Association Between Acute Hyperglycemia and Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention

For patients with ST-segment elevation myocardial infarction (STEMI), primary percutaneous coronary intervention (PCI) is superior to fibrinolytic therapy alone in reducing the composite end points of death, re-infarction, intracranial bleeding, re-occlusion of the infarct artery, and recurrent ischemia.Objective: This study aimed at determining the association between admission blood glucose levels and the risk of subsequent CIN in patients with STEMI who underwent primary PCI. In-hospital mortality rate was also evaluated as a secondary end pointMethods: This study included 40 patients who presented to the emergency department of the National Heart Institute with acute ST- elevation myocardial infarction and were treated with primary PCI. All patients were subjected to full history taking with special emphasis on known predisposing factors for CIN, thorough clinical examination, Primary PCI was performed by a 24-hours on-call interventional team according to standard clinical practice, an echocardiographic evaluation, blood glucose on admission and serum creatinine was measured at the time of admission (just before primary PCI), and every day for the following three days in the CCU.Results: In the current study, all in-hospital complications occurred more frequently in the hyperglycemic group. There was also a statistically significant difference as regard to decrease ejection fraction in the hyperglycemic group compared to non-hyperglycemic one. In our study admission serum glucose level was associated with more incidence of CIN and mortality. In our study, acute hyperglycemia was associated with increased CIN risk whether patients had DM or not. DM was not a significant risk factor for CIN.Conclusion: In STEMI patients treated with primary PCI, acute hyperglycemia was associated with a higher CIN risk and more incidence of in-hospital morbidity and mortality..