A associação entre o delta da glicemia, massa infartada e função ventricular esquerda
Data
2024-05-20
Autores
Garcia, Bernardo Fontes 
Orientadores
Bianco, Henrique Tria
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
ntrodução: doenças metabólicas estão em crescente incidência, contribuindo para múltiplas complicações cardiovasculares. Estratégias de baixo custo e com fácil implementação têm sido propostas. A detecção do delta da glicemia e sua correlação com os desfechos cardiovasculares, desponta como um promissor biomarcador. Objetivo: avaliar a correlação entre o delta da glicemia e o comprometimento ventricular esquerdo, quantificado por meio da ressonância magnética cardíaca (RNMc) em pacientes com infarto agudo do miocárdio com supradesnível do segmento ST (IAMCSST). Métodos: amostra incluiu consecutivamente 244 pacientes com IAMCSST, submetidos à estratégia fármaco-invasiva. Foram obtidas amostras de parâmetros glicêmicos no primeiro dia de hospitalização, incluindo glicemia basal, HbA1c, delta da glicemia (glicemia basal - glicemia média estimada), variáveis lipídicas, marcadores de inflamação e de necrose miocárdica. A RNMc foi realizada após 30 dias do evento agudo. Resultados: foi obtida correlação do delta da glicemia com a massa ventricular infartada (Rho: 0,25; p<0,01), e relação inversa como a fração de ejeção ventricular esquerda (Rho: -0,21; p=0,02). Conclusão: o delta da glicemia apresenta-se como um marcador independente a ser considerado na avalição prognóstica e preditiva em pacientes acometidos por IAM.
Background: metabolic diseases are increasing contributing to multiple cardiovascular complications. Low-cost affordable strategies have been proposed. The detection of glycemia delta and its correlation with cardiovascular outcomes have been considered a promising new biomarker. Objective: this study aimed to evaluate the correlation between glycemia delta with left ventricular infarcted mass, quantified by cardiac magnetic resonance imaging (cMRI), in patients with ST segment elevation myocardial infarction (STEMI). Methods: a sample of 244 consecutive patients with STEMI, submitted to pharmaco-invasive strategy, were included in the study. Blood samples of glycemic parameters were collected in the first day of hospitalization and included glycemia, HbA1c, and glycemia delta (estimated mean glycemia based on HbA1c), lipid profiles, biomarkers of inflammation and myocardial necrosis. The cMRI was performed 30 days after the acute event. Results: we found a positive correlation between delta glycemia and the infarcted area (Rho: 0.25; p<0.01), and an inverse relationship with left ventricular ejection fraction (Rho: -0.21; p=0.02). Conclusion: glycemic delta was found as an independent marker to be considered for prognostic assessment of patients with STEMI.
Background: metabolic diseases are increasing contributing to multiple cardiovascular complications. Low-cost affordable strategies have been proposed. The detection of glycemia delta and its correlation with cardiovascular outcomes have been considered a promising new biomarker. Objective: this study aimed to evaluate the correlation between glycemia delta with left ventricular infarcted mass, quantified by cardiac magnetic resonance imaging (cMRI), in patients with ST segment elevation myocardial infarction (STEMI). Methods: a sample of 244 consecutive patients with STEMI, submitted to pharmaco-invasive strategy, were included in the study. Blood samples of glycemic parameters were collected in the first day of hospitalization and included glycemia, HbA1c, and glycemia delta (estimated mean glycemia based on HbA1c), lipid profiles, biomarkers of inflammation and myocardial necrosis. The cMRI was performed 30 days after the acute event. Results: we found a positive correlation between delta glycemia and the infarcted area (Rho: 0.25; p<0.01), and an inverse relationship with left ventricular ejection fraction (Rho: -0.21; p=0.02). Conclusion: glycemic delta was found as an independent marker to be considered for prognostic assessment of patients with STEMI.
Descrição
Citação
GARCIA, Bernardo Fontes. A associação entre o delta da glicemia, massa infartada e função ventricular esquerda, 2024. 98 f. Tese (Doutorado em Cardiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.