Predictive Value of Stress Hyperglycemia Ratio on Intracoronary Thrombus Burden in Patients with ST Segment Elevation Myocardial Infarction | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 103, Volume 98, Issue 1, January 2025, Page 713-719 PDF (790.82 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.410683 | ||||
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| Abstract | ||||
| Background: Primary percutaneous coronary intervention (PCI) is the recommended treatment for ST-segment elevation myocardial infarction (STEMI). Substantial coronary thrombus during primary PCI is associated with a poor prognosis. While stress hyperglycemia is common in STEMI patients, its association with intracoronary thrombus extent is uncertain. Patients and Methods: The study included 100 STEMI patients eligible for primary PCI within 12 hours of symptom onset. SHR was calculated by dividing admission glucose by the estimated average glucose derived from HbA1c. Intracoronary thrombus burden was angiographically assessed using the Thrombolysis in Myocardial Infarction (TIMI) thrombus grade scale. Patients with thrombus grades 1 to 3 were categorized as the small thrombus burden (STB) group, and those with grades 4 and 5 as the large thrombus burden (LTB) group. Results: SHR was significantly higher in the LTB group compared to the STB group (p=0.016), regardless of diabetic status. SHR demonstrated significant predictive value for LTB when the cut-off value exceeded 1.37, with a sensitivity of 67.24% and a specificity of 54.76%. Both univariate and multivariate analyses showed that LTB was independently predicted by SHR and admission blood glucose levels. No relationship was found between SHR and post-primary PCI TIMI flow grade or in-hospital clinical outcome. Conclusions: SHR and admission hyperglycemia were independent predictors for LTB incidence in STEMI patients. | ||||
| Keywords | ||||
| Stress hyperglycemia ratio; ST-segment elevation myocardial infarction; Intracoronary thrombus burden | ||||
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