Prognostic Impact of Combined Dysglycemia and Hypoxic Liver Injury (HLI) at Admission in Patients with ST-Elevation Myocardial Infarction (STEMI) Undergone Primary Percutaneous Coronary Intervention (PCI) :Data from INTERSTELLAR cohort

초록

Objectives Dysglycemia at admission is known to predict the prognosis of ST-elevation myocardial infarction (STEMI). Recently, hypoxic liver injury (HLI) at admission has been proposed as a novel prognostic marker for STEMI. Therefore, we sought to evaluate the prognostic impact ofcombined dysglycemia and HLI at admission in patients with STEMI undergoneprimary PCI. Methods From 2007 to 2014, a total of 1497consecutive patients (79.3% male, mean age 60.5±13.1 years) who underwentprimary PCI for STEMI were analyzed retrospectively.Dysglycemia was defined as either hypoglycemia (serum glucose <90 mg/dl) or hyperglycemia (serum glucose ≥200 mg/dl). HLI was defined as ≥2-fold increase of any serum aminotransferase above upper normal limit. Patients were divided into six groups according to their dysglycemia and HLIstatus at admission. Primary endpoint was in-hospital mortality and secondary endpoint was all-cause mortality at 12 months after index procedure. Results Of the 1497 patients, there were 19 (1.3%) patients in group 1, 882 (58.9%) patients in group 2, 278 (18.6%) patients in group 3, 7 (0.5%) patients in group 4, 215 (14.4%) patients in group 5, and 96 (6.4%) patients in group 6.Over a mean follow-up period of 2.1±1.5 years, there were 85 (5.7%) in-hospital mortality and 121 (8.1%) all-cause mortality.The in-hospital mortality rates were the highest in group 4 (57.1%), followed by group 6 (28.1%) and were always higher in HLI(+) groups than in HLI(-) at the same glucose status (Figure 1). Conclusions Combined dysglycemia and HLI at admission is associated with early mortalityin patients with STEMI underwent primary PCI. Hypoglycemia at admission is associated with mid-term STEMI mortality