# The Association of Peak Glycemia and No‐Reflow Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention

## TL;DR

High blood sugar levels are strongly linked to poor heart artery reflow in heart attack patients undergoing a specific treatment.

## Contribution

This study identifies peak glycemia above 180 mg/dL as an independent risk factor for no-reflow in STEMI patients.

## Key findings

- 42.4% of STEMI patients experienced no-reflow after PPCI.
- Peak glycemia above 180 mg/dL independently increased no-reflow odds by 8.16 times.
- No-reflow was also associated with diabetes, smoking, and high LDL cholesterol.

## Abstract

This study investigates the effect of peak glycemia on the no‐reflow phenomenon in patients with ST‐elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) to examine the relationship between elevated blood glucose (BG) levels and no‐reflow.

A total of 252 STEMI patients (81.7% male) who underwent PPCI were enrolled. BG was measured by a glucometer every 6 h for 24 h, starting at the time of patient admission. The maximum measured BG was considered the peak glycemic level. A corrected TIMI frame count (CTFC) of less than 27 was used to define the no‐reflow phenomenon in this study.

42.4% of participants experienced no flow, with a significant association between this condition and diabetes mellitus, peak glycemia, smoking history, and elevated LDL cholesterol levels. Specifically, peak glycemia levels above 180 mg/dL independently increased the odds of no‐reflow occurrence (OR = 8.16, 95% CI = 4.1–16.2, p < 0.001).

The importance of monitoring BG levels in STEMI patients, as well as the critical role of a multidisciplinary approach, regardless of diabetic status, in mitigating the risk of no‐reflow and improving clinical outcomes, should be highlighted.