2019, Number 2
Leuko-glycemic index as a prognostic factor after acute myocardial infarction with ST-segment elevation
Full text
Language: Spanish
References: 22
Page: 97-107
PDF size: 437.42 Kb.
ABSTRACT
Foundation: blood glucose and leukocyte count at admission have shown prognostic significance in patients with myocardial infarction. Leuko-glycemic index is a recently proposed marker as a predictor of mortality.Objective: to evaluate the usefulness of the leuko-glycemic index in the stratification of the risk of in-hospital death after STEMI.
Method: a prospective observational study was conducted which included all patients admitted consecutively with a diagnosis of acute myocardial infarction with ST segment elevation and Killip> I class, from January 2012 to June 2015 at the Provincial University Hospital Camilo Cienfuegos Gorriarán. Clinical, laboratory and echocardiographic data were collected and the prognostic implication of the leuko-glycemic index in in-hospital mortality was determined through binary logistic regression. The studied variables were: age, sex and color of the skin, medical history and cardiovascular risk factors, clinical data such as systolic and diastolic blood pressure as well as heart rate at admission.
Results: LGI was a predictor of mortality in both diabetic and non-diabetic patients (c = 0.673 and c = 0.707) respectively. There was a positive correlation between the Killip class and the leuco-glycemic index (r: 0.471 p <0.001). The 75th percentile showed an acceptable sensitivity and good specificity as a predictor of complications and mortality after STEMI.
Conclusions: the leuko-glycemic index in the course of an acute myocardial infarction can be associated with a higher in-hospital mortality. Its detection would be useful in the prognostic stratification of acute coronary syndrome.
REFERENCES
Ibáñez B, James S, Agewall S, Antunes MJ, Bucciarelli C, Bueno H, et al. Guía ESC 2017 sobre el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev Esp Cardiol [revista en Internet]. 2017 [citado 23 Oct 2018];70(12):[aprox. 6p]. Disponible en: http://www.revespcardiol.org/es/guia-esc-2017-sobre-el/articulo/90461843/ [Buscar en Google Scholar]
O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2013;82(1):1-27 [Buscar en Google Scholar]
Millard RW, Tranter M. Biomarcadores no troponínicos, complementarios, alternativos y presuntos, para el síndrome coronario agudo: nuevos recursos para los futuros instrumentos de cálculo del riesgo. Rev Esp Cardiol [revista en Internet]. 2014 [citado 24 Oct 2018];67(4):[aprox. 8p]. Disponible en: http://www.revespcardiol.org/es/biomarcadores-no-troponinicos-complementarios-alternativos/articulo-resumen/90283557/ [Buscar en Google Scholar]
Shah B, Baber U, Pocock SJ, Krucoff MW, Ariti C, Gibson CM, et al. White Blood Cell Count and Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention in the Contemporary Era: Insights From the PARIS Study (Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Registry). Circ Cardiovasc Interv. 2017;10(9):e004981 [Buscar en Google Scholar]
Martins H, Monteiro S, Goncalves F, Monteiro P, Pego M. Glucemia en los síndromes coronarios agudos. ¿Hasta qué nivel debe reducirse?. Rev Esp Cardiol [revista en Internet]. 2015 [citado 2 Feb 2017];68(1):[aprox. 5p]. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0300893214002152.pdf?locale=es_ES&searchIndex [Buscar en Google Scholar]
Gómez D, Sánchez G, Pérez M, García RG, Arguello JF, Peñaherrera E, et al. Hiperglucemia se asocia a mayor número de desenlaces adversos en individuos latinoamericanos con infarto agudo de miocardio. Clin Invest Arterioscl [revista en Internet]. 2016 [citado 23 Oct 2018];28(1):[aprox. 9p]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0214916815001291 [Buscar en Google Scholar]
Cabrerizo JL, Gimeno JA, Zalba B, Pérez JI. La hiperglucemia como factor de mal pronóstico en el síndrome coronario agudo. Rev Clin Esp [revista en Internet]. 2011 [citado 12 Ene 2018];211(6):[aprox. 3p]. Disponible en: https://www.revclinesp.es/es-la-hiperglucemia-como-factor-mal-articulo-S0014256511001135 [Buscar en Google Scholar]
Quiroga W, Conci E, Zelaya F, Isa M, Pacheco G, Sala J, et al. Estratificación del riesgo en el infarto agudo de miocardio según el índice leucoglucémico. ¿El Killip-Kimball de laboratorio?. Rev Fed Arg Cardiol [revista en Internet]. 2010 [citado 23 Feb 2018];39(1):[aprox. 5p]. Disponible en: http://www.fac.org.ar/1/revista/10v39n1/art_orig/arorig01/quiroga.pdf [Buscar en Google Scholar]
Górriz JL, Beltrán S. Valoración de afección renal, disfunción renal aguda e hiperpotasemia por fármacos usados en cardiología y nefrotoxicidad por contrastes. Rev Esp Cardiol [revista en Internet]. 2011 [citado 24 Nov 2018];64(12):[aprox. 10p]. Disponible en: http://www.revespcardiol.org/es/valoracion-afeccion-renal-disfuncion-renal/articulo/S0300893211007743/ [Buscar en Google Scholar]
Bedetti G, Gargani L, Sicari R, Gianfaldoni ML, Molinaro S, Picano E. Comparison of Prognostic Value of Echocardiacgraphic Risk Score With the Thrombolysis In Myocardial Infarction (TIMI) and Global Registry In Acute Coronary Events (GRACE) Risk Scores in Acute Coronary Syndrome. Am J Cardiol. 2010;106(12):1709-16 [Buscar en Google Scholar]
García Y, González CM, Jorrín FR, Valladares FJ, Navarro JJ, Castillo S. Hiperglicemia, marcador pronóstico de eventos adversos en el infarto agudo de miocardio. Rev Cubana Cardiol Cir Cardiovasc [revista en Internet]. 2014 [citado Jun 11];19(2):[aprox. 6p]. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/342 [Buscar en Google Scholar]