Abstract 17440: Glycemic Variability Inflicts Injury on Non-infarct Area in Patients With Anterior ST-segment Elevation Myocardial Infarction
Background: Glycemic variability (GV) plays an important role in patients with ST-segment elevation myocardial infarction (STEMI), but the relationship between GV and the strain of left ventricle by cardiac magnetic resonance imaging (CMR) has not been examined.
Methods: We investigated 55 patients with anterior STEMI who underwent reperfusion therapy within 12h onset. We analyzed GV, as determined by a continuous glucose monitoring system (CGMS; iPro2, Medtronic, Minneapolis, USA), and circumferential strain (CS) of the left ventricule by CMR. All patients were equipped with CGMS in a stable phase after admission. CMR were performed 7days and 7 months repeatedly. We checked CS at each segment as regional function and global CS as global function. Patients were classified into 2 groups according to the mean amplitude of glycemic excurtions (MAGE) that was calculated by measuring the arithmetic mean of the differences between consecutive peaks and nadirs if the differences were greater than 1 standard deviation; high-MAGE group and low-MAGE group.
Results: There were no significant differences between high-MAGE and low-MAGE group regarding age (63.4±13.0 vs. 64.0±11.6 years) ,male gender (85% vs. 78%). High-MAGE group had more frequently with diabetes (44% vs. 3%, p<0.001), greater peak creatine phosphokinase (CPK; 4619 vs. 2934U/L, p=0.02), lower global CS (-15.4±2.8% vs. -18.1±5.0%, p=0.01) and mid-inferior CS (-16.8±6.6% vs. -20.6±6.7%, p=0.04) at 7 months CMR.
At late CMR, MAGE had significant correlation with global CS (R=0.3, p=0.024) and CS at mid-inferior (R=0.35, p=0.009). Multivariate analysis revealed that MAGE (β=0.35, p=0.009) were independently correlated with CS at mid-inferior, and peak CPK (β=0.398, p=0.003) were independently correlated with global CS.
Conclusion: GV inflicted injury on non-infarct area after the onset of anterior STEMI. This may be related to left ventricular remodeling.
Author Disclosures: Y. Minaimoto: None. N. Iwahashi: None. M. Gohbara: None. S. Kataoka: None. E. Akiyama: None. N. Maejima: None. K. Tsukahara: None. K. Hibi: Research Grant; Modest; AstraZeneca Co., Ltd, MSD Co., Ltd, Solve Co., Ltd, Biosensors Japan Co., Ltd, Teijin Pharma Co., Ltd, Terumo Co., Ltd, Mochida Pharmaceutical Co., Ltd. Research Grant; Significant; Goodman Co., Ltd, Medtronic Japan Co., Ltd, St. Jude Medical Japan Co., Ltd. Honoraria; Modest; Daiichi-Sankyo Co., Ltd, Boston Scientific Japan Co., Ltd. Consultant/Advisory Board; Modest; Terumo Co., Ltd, St. Jude Medical Japan Co., Ltd. M. Kosuge: Other Research Support; Significant; Toa Eiyo Ltd. T. Ebina: None. S. Umemura: Research Grant; Modest; Torii, Dainippon-Sumitomo. Research Grant; Significant; Pfizer, Astellas, Daiichi-Sankyo, Astrazeneca, Nihon-Boehringer-Ingelheim. Honoraria; Modest; Daiichi-Sankyo, MSD, Takeda. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan Research Institute for Production Development, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer-Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca, Toa Eiyo Ltd. Honoraria; Significant; MSD, Bayer, Daiichi-Sankyo.
- © 2015 by American Heart Association, Inc.