Effect of diabetes on scintigraphic infarct size in STEMI patients undergoing primary angioplasty

Background: It has been shown that among patients with ST-segment elevation myocardial infarction (STEMI), diabetes is associated with a significantly higher mortality, mainly because of impaired reperfusion. However, few data have been reported so far on infarct size as evaluated by well-refined techniques, such as nuclear imaging techniques. Therefore, the aim of the current study was to investigate the effect of diabetes in infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI. Methods: We included 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99 m-sestamibi. A logistic regression analysis was performed to determine the relation between diabetes and infarct size (as above the median) after correction for baseline confounding factors. Results: A total of 115 (13.8%) out of 830 patients suffered from diabetes. Diabetic patients were older (p<0.001), with larger prevalence of female gender (p=0.006) and hypertension (p=0.001) but were less often smokers (p=0.003). Diabetic patients had more often preprocedural thrombolysis in myocardial infarction grade 3 flow (p=0.034) and less complete ST-segment resolution (p=0.009). No difference was observed in scintigraphic infarct size between diabetes and control patients (p=0.6)), which was confirmed at multivariate analysis after correction for baseline confounding factors (Adjusted OR [95% CI]=0.87 [0.57-1.31, p=0.51). Conclusion: Our study showed that among STEMI patients undergoing primary angioplasty, diabetes did not affect infarct size as compared with non-diabetic patients.