The value of fructosamine in prediction of angiographic outcomes and MACE in diabetic patients presented with anterior ST segment elevation acute coronary syndrome undergoing their first primary PCI

Abstract

Background: Cardiovascular diseases are the leading most common cause of death in industrialized countries. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction and failure of different organs especially heart and blood vessels.

Objective: To study the predictive value of Fructosamine as a marker of short-term glycemic control over 2-3 weeks on the angiographic and clinical outcomes in diabetic patients presented with anterior STEMI in Ain shams university hospital.

Patients and Methods: This is an observational study recruiting 100 patients presented with anterior STEMI who underwent their first primary percutaneous coronary intervention (PPCI) from May 2020 to December 2020.

Results: Angiographic results of patients post PCI were as follows: Regarding Thrombolysis in myocardial infarction (TIMI Flow), 8 patients had TIMI flow 0, 18 had TIMI I, 27 had TIMI II and 37 had TIMI III flow. Regarding myocardial blush grade (MBG) 12 patients had MBG grade 0, 27 had grade I, 20 had grade II and 4 had grade III. During follow up for one-month, Major adverse cardiac events (MACE) occurred in 56% of patients. Measured serum Fructosamine levels were ranging between (233 to 557 µmoll/L) the results showed a strong correlation between serum Fructosamine and TIMI flow MBG. Patients with higher Fructosamine level had worsen TIMI flow and MBG and more occurrence of MACE in diabetic patients after PPCI. Conclusion: High Fructosamine level can be used as a predictor for worse outcomes in diabetic patients presented with Anterior STEMI.