Glycated Hemoglobin as a Predictor of No Reflow in Diabetic Patients with ST Segment Elevation Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention

Abstract Background Prognosis after myocardial infarction in patients with diabetes mellitus is worse compared with patients without diabetes mellitus, even in the setting of optimal reperfusion strategy involving primary percutaneous intervention (PCI). Objective To detect the correlation between HbA1C and no reflow in diabetic patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention. Methods In this comparative cross-sectional study, we examined 62 diabetic patients who experienced an acute STEMI and had undergone PCI at Ain Shams University Hospitals and Nasr City Hospital for Health Insurance in a period of six months starting from February 2023 till August 2023. These patients were divided into two groups. Group 1 consisted of 31 diabetic patients who exhibited normal blood flow following PCI. Group 2 included an equal number of patients (31) who demonstrated no-reflow phenomenon. Results A total of 62 participants were included, with 5 females (8.1%) and 57 males (91.9%), ranging in age from 39 to 83 years. The mean age of the participants was 61.1 years. Statistical analysis showed no significant differences in age and gender distribution between the normal flow group and the no-reflow group, with p-values of 0.151 and 0.641, respectively. There was no statistically significant difference between the two groups regarding physical examination except for diastolic blood pressure that was lower in no reflow group. Also, There was no statistically significant difference between the two groups regarding HbA1C level. Mean with 95% confidence interval (CI) of 7.69 (6.86 – 8.52) in normal flow group and 8.05 (7.02 – 9.7) in no reflow group. Conclusion In this study of diabetic patients with STEMI undergoing primary PCI, we found no statistically significant correlation between HbA1C levels and the occurrence of the “no reflow” phenomenon., although there was a trend towards higher HbA1C in the no reflow group which may need conducting large-scale studies involving a more diverse population.