ST Elevation (STEMI) Myocardial Infarction
Conditions
Keywords
ST-segment elevation Myocardial Infarction, triglyceride glucose index, Cardiac magnetic resonance, myocardial infarct size, intramyocardial hemorrhage, microvascular obstruction
Brief summary
This research aim is to investigate the correlation between triglyceride glucose index (TyG index) and myocardial infarct size, microcirculation obstruction (MVO) and intramyocardial hemorrhage (IMH) assessed by cardiac magnetic resonance imaging (CMR) in patients with ST-segment elevation myocardial infarction (STEMI), and to evaluate its value as a potential predictor of myocardial injury.To further determine the influence of TyG index on the prognosis of STEMI patients after PCI.This cohort included 674 patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). Baseline clinical data were collected and cardiac magnetic resonance imaging was performed approximately 7 days after Acute Myocardial Infarction(AMI). Patients were divided into three groups according to the TyG index , namely high TyG index group, medium TyG index group and low TyG index group. Multiple linear regression, Pearson/Spearman correlation analysis and Logistics regression analysis were used to analyze the correlation between TyG index and myocardial infarct size, microcirculation obstruction and intramyocardial hemorrhage.Eventually, we came to the conclusion that the TyG index was independently associated with severity of myocardial injury after STEMI as assessed by CMR. TyG index is not only an independent predictor of microcirculation disturbance in STEMI patients, but also significantly correlated with poor cardiovascular prognosis. is a powerful marker for stratifying risk of adverse cardiovascular events.
Interventions
None listed
Sponsors
Beijing Anzhen Hospital
Beijing Chao Yang Hospital
Second Affiliated Hospital of Nanchang University
First People's Hospital of Yulin
Wuhan Asia Heart Hospital
Zunyi Medical College
Chinese PLA General Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 1\) patients meet diagnostic criteria for STEMI-The priority for these patients is the implementation of reperfusion therapy as soon as possible .In the appropriate clinical context,ST-segment elevation (accessed at the J-point) indicates possible acute coronary artery in the following situations:New ST elevation at the J-point in at least two contiguous leads:·≥ 2.5 mm in men under 40years,≥2mm in males 40 years and older,or ≥1.5mmin women relatively less of age in leads V2-V3,and/or ≥1mm in the other leads (in the absence of left ventricular hypertrophy or left bundle branch block) Post-STEMI reperfusion with PCI, diagnosis and treatment strategy in accordance with current diagnosis and treatment standards and guidelines27 and complete pPCI within 48h- diagnostic strategy meets current diagnostic criteria and guidelines;2) KillIP\<3 and consent to CMR examination and follow-up observation, and CMR examination is completed within 7 days after surgery. 3) Monitor baseline blood glucose and baseline triglycerides during admission.
Exclusion criteria
1) Patients with NSTEMI 2) Lack of clinical data 3) Presence of contraindications to CMR examination-such as implantable cardiac pacemaker, clo gadolinium contrast agent or renal insufficiency; meanwhile, patients with Killip IV cardiac function or clinical instability, and patients with valvular disease, congenital heart disease, pulmonary hypertension, cardiomyopathy history, persistent atrial fibrillation, etc. affecting cardiac structure and function parameters were excluded; Patients with previous history of myocardial infarction, coronary artery intervention and coronary artery bypass grafting were also excluded; patients with severe clinical diseases such as severe hematological diseases, infectious diseases, malignant tumors, liver and kidney failure, and mental disorders or intellectual disabilities who could not cooperate with examination and follow-up; 4) patients with poor MRI quality or sequence deletion were not included in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| major adverse cardiovascular events | 4 years after discharge | Death , recurrence of myocardial infarction, heart failure after discharge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Microvascular occlusion | Cardiac MRI within 7 days after surgery | T1-weighted sequences are acquired from CMR and analyzed by software.Identified by early or late gadolinium-enhanced imaging using T1-weighted sequences with high inversion times |
| Intramyocardial hemorrhage (IMH) | Cardiac MRI within 7 days after surgery | IMH was detected by T2-weighted imaging or T2 mapping, identified using low signal areas. |
| myocardial infarct size | Cardiac MRI within 7 days after surgery | LGE sequences are acquired from CMR .The LGE images were analyzed manually or semi-automatically with software tools to calculate the size or volume of the infarct area . |
Countries
China
Outcome results
None listed