Journal
MEDICAL SCIENCE MONITOR
Volume 24, Issue -, Pages 3549-3556Publisher
INT SCIENTIFIC LITERATURE, INC
DOI: 10.12659/MSM.908980
Keywords
Acute Coronary Syndrome; Diabetes Mellitus, Type 2; Endothelin-1; No-Reflow Phenomenon; Percutaneous Coronary Intervention
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Funding
- Affiliated Hospital of Jining Medical University
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Background: No-reflow phenomenon is a well-known problem, often accompanying percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEAMI). This study investigated the value of plasma D-dimer and Endothelin-1 (ET-1) levels on admission in predicting no-reflow after primary PCI and longterm prognosis in STEAMI patients with type 2 diabetes mellitus (T2DM). Material/Methods: There were 822 patients with STEAMI and T2DM undergoing successful primary PCI included in this study: 418 patients showed normal re-flow after PCI, while 404 patients showed no-reflow phenomenon after PCI. The predictive value of plasma ET-1 and D-dimer level, and other clinical parameters for the no-reflow phenomenon were analyzed. Results: The high plasma ET-1 and D-dimer levels showed predictive value for the no-reflow phenomenon in STEAMI patients with T2DM. Patients with high D-dimer and ET-1 levels showed higher risk (4.212, with 95% CI of 2.973-5.967 and 2.447 with 95% CI of 1.723-3.476, respectively) of no-reflow phenomenon compared with patients with low plasma D-dimer and ET-1 levels. Sensitivity of high plasma ET-1 and D-dimer levels in predicting no-reflow was 0.766. Both plasma D-dimer and ET-1 were adverse prognosticators for STEAMI patients with a T2DM post PCI (P<0.001). Conclusions: In conclusion, plasma D-dimer and ET-1 levels on admission independently predict no-reflow after PCI in STEAMI patients with T2DM. When combined, the D-dimer and ET-1 levels as predictive and prognostic values are clinically promising. The plasma D-dimer and ET-1 levels provided a novel marker for treatment selection for the STEAIM patients with a T2DM history.
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