Effect of intracoronary thrombectomy on 30-day mortality in non-diabetic patients with acute hyperglycemia after acute myocardial infarction

Background: There is limited evidence about useful therapeutic interventions for patients with acute hyperglycemia (AH) after acute myocardial infarction (AMI). Methods: We studied 2433 consecutive non-diabetic AMI patients who underwent percutaneous coronary intervention (PCI) within 24 h after the onset. Patients were divided into two groups according to the presence or absence of AH (admission serum glucose level >= 11.1 mmol/l). We assessed the association between intracoronary thrombectomy and the clinical outcome in AMI patients with AH. Results: Patients with AH had more risk factors than those without AH. The 30-day mortality rate of patients with AH was significantly higher than that of those without (11.7% vs 1.7%, p < 0.001). Among patients with AH, the 30-day mortality rate was significantly tower for those with intracoronary thrombectomy than those without it (4.9% vs 17.2%, p = 0.004). Among patients without AH, however, the 30-day mortality rate was similar between those with and without intracoronary thrombectomy (1.5% vs 1.9%, p = NS). Multivariate analysis showed that intracoronary thrombectomy was associated with an improved 30-day mortality rate for patients with AH (hazard ratio: HR 0.184, 95% Cl 0.057-0.598, p = 0.005). Conclusions: In AMI patients with AH, intracoronary thrombectomy prior to PCI might improve the 30-day mortality rate. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.