Introduction: Numerous studies revealed that hyperglycemia in patients undergoing percutaneous coronary intervention (PCI) increases the risk of acute kidney injury (AKI) in hospital admission individuals. However, there is a little data regarding the effect of long-standing hyperglycemia on the presence of AKI in patients with myocardial infarction undergoing primary PCI.
Objectives: In this study, we investigated the effect of chronic poor glycemic control (using HbA1c, as an index of glucose control in the last 2-3 months) on AKI occurrence in individuals with type 2 diabetes mellitus (T2DM) and ST-elevation myocardial infarction (STEMI) undergoing coronary angiography and primary PCI.
Patients and Methods: We prospectively studied 120 patients with T2DM and STEMI undergoing primary PCI. According to glycosylated hemoglobin (HbA1c), individuals were divided into two groups, patients with HbA1c<7% (group 1, n = 47) and patients with HbA1c ≥ 7% (group 2, n = 73). Medical records of both groups were reviewed for the occurrence of AKI.
Results: AKI was found in 3 of 47 patients (6.38%) in group 1 and in 16 of 73 patients (21.9%) in group 2 (P = 0.043). There was no statistically difference in baseline serum creatinine and estimated glomerular filtration rate between the two groups. Group 2 had significantly higher HbA1c (8.6 ±1.6 vs. 5.8 ±1.2 %; P = 0.001) and higher admission glucose levels (259 ± 95 mg/dL vs. 163 ± 71 mg/dL; P = 0.001)
Conclusion: Elevated HbA1c was associated with higher risk of AKI in T2DM with STEMI who treated with primary PCI.