Currently, the gold standard treatment for ST-elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI), but even after successful pPCI, a perfusion disorder in the epicardial coronary arteries, termed no-reflow phenomenon (NR), can develop, resulting in short- and long-term adverse events. The present study assessed the relationship between NR and HbA1c/C-peptide ratio (HCR) in 1834 consecutive patients who underwent pPCI due to STEMI. Participants were divided into two groups according to NR status and the demographic, clinical and periprocedural characteristics of the groups were compared. NR developed in 352 (19.1%) of the patients in the study. While C-peptide levels were significantly lower in the NR group, HbA1c and HCR were significantly higher (P < .001, for all). In multivariable analysis, C-peptide, HbA1c, and HCR, were determined as independent predictors for NR (P < .05, for all). In Receiver Operating Characteristic (ROC) analysis, HCR predicted the NR with 80% specificity and 77% sensitivity. In STEMI patients, combining HbA1c and C-peptide in a single fraction has a predictive value for NR independent of diabetes. This ratio may contribute to risk stratification of STEMI patients.

中文翻译：

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HbA1c/C 肽比率与 ST 段抬高型心肌梗死患者的无复流现象相关。

目前，ST段抬高型心肌梗死（STEMI）的金标准治疗是直接经皮冠状动脉介入治疗（pPCI），但即使在成功进行pPCI后，心外膜冠状动脉的灌注障碍也可能出现，称为无复流现象（NR）。 ，导致短期和长期不良事件。本研究评估了 1834 名因 STEMI 接受 pPCI 的连续患者的 NR 与 HbA1c/C 肽比值 (HCR) 之间的关系。根据 NR 状态将参与者分为两组，并比较各组的人口统计学、临床和围手术期特征。研究中 352 名患者 (19.1%) 出现 NR。虽然 NR 组的 C 肽水平显着较低，但 HbA1c 和 HCR 显着较高（全部 P < .001）。在多变量分析中，C 肽、HbA1c 和 HCR 被确定为 NR 的独立预测因子（全部 P < .05）。在接受者操作特征 (ROC) 分析中，HCR 预测 NR 的特异性为 80%，敏感性为 77%。在 STEMI 患者中，将 HbA1c 和 C 肽组合在一个分数中具有独立于糖尿病的 NR 预测价值。该比率可能有助于 STEMI 患者的风险分层。