Predictive Value of Glycated Albumin Electrocardiographic ST-segment Resolution in Patients with acute STEMI Undergoing Primary Percutaneous Coronary Intervention

Abstract

Glycated hemoglobin A1c (HbA1c) levels are widely considered important indicators of blood sugar control, as studies have shown that HbA1c can predict the severity of coronary artery disease as well as its poor prognosis. In cases where HbA1c is limited, glycosylated albumin (GA) will be a suitable surrogate indicator. The aim of this study is to evaluate the predictive value of glycated albumin in electrocardiographic ST-segment resolution in patients with acute STEMI undergoing primary percutaneous coronary intervention. Materials and Methods: In this cross-sectional study, patients with STEMI who underwent PPCI during one year from September 2022 to September 2023 at Shahid Madani Hospital of Tabriz University of Medical Sciences were included in the study. The sample size was calculated to be 128 samples. Patients were divided into 2 groups based on STR of at least 50%, presence or absence of hospital MACCE, EF≥40%, and six-month mortality, and were compared with demographic findings, laboratory findings, and angiography findings. The results were also analyzed in two subgroups of diabetics and non-diabetics. ROC curves and Area Under Curve (AUC) value were used to check the predictive value of glycosylated albumin for STR. In order to check 6-month mortality, follow-up of patients was done by telephone. Results: In this study, the mean (standard deviation) of creatinine and total albumin in the studied patients were 1.12 (±0.3) and 4.12 (±0.4), respectively. Also, the mean (SD) of glycated albumin, ratio of glycated albumin to total albumin and ejection fraction in these patients were 0.33 (±0.1), 8.10 (±2.4) and 36.70 (±7.7), respectively. The most culprit vessels in the studied subjects were LAD with 80 cases (62.0%) and RCA with 35 cases (27.2%). The highest number of vessels involved in the studied subjects was SVD with 59 cases (45.7%), 2VD with 46 cases (36.4%), and 3VD with 20 cases (15.5%), respectively. The electrocardiographic ST-segment resolution was less than 50 in 37 cases (28.9%) of the patients and 50 and more in 91 cases (71.1%) of the patients. Also, MACCE was positive in 5 cases (3.9%) of these patients. Finally, in 2 cases (1.6%) of these patients, death occurred in six months. Glycated albumin did not significantly predict MACCE, six-month mortality, the electrocardiographic ST-segment resolution and Ejection fraction in the studied patients (P>0.05). Between the variables of MACCE, six-month mortality, the electrocardiographic ST-segment resolution, and ejection fraction with glycosylated albumin, total albumin, the number of involved vessels, age and gender, only between the ejection fraction and the number of involved vessels, a statistically significant relationship was observed (P=0.007). Also, in the two groups of diabetic and non-diabetic patients studied, there was no significant relationship between the electrocardiographic ST-segment resolution and EF with glycosylated albumin (P>0.05).