Alteration of stress hormones and glucose levels after percutaneous coronary intervention in patients with acute myocardial infarction and its influence on prognosis

Objective Acute myocardial infarction(AMI)can lead to a series of neuroendocrine changes and results in severe stress,causes critical complications.This study investigates the alteration of stress hormones and glucose levels and its prognostic value after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.Methods A total of 115 non-diabetics patients with ST elevation MI (STEMI) receiving PCI were divided into 2 groups according to Serum Glucose(SG)levels at admission:Group A,SG7.8 mmol/L(n=68);Group B,SG≥7.8 mmol/L(n=47).Stress hyperglycaemia was defined as random SG level greater than or equal to 7.8 mmol/L on admission.We compared the clinical data and stress hormones and investigated heart failure,reinfarction,post-infarction angina,serious arrhythmias,and cardiac death in the 2 groups.Results The incidence of stress hyperglycaemia was 40.87% in our group.The stress hormone levels in group B(cortisol,growth hormone,glucagons,ACTH) were significantly higher than those in group A(P0.01).The insulin level in group B was significantly lower than that in group A(P0.01).The incidences of heart failure,reinfarction,post-infarction angina,serious arrhythmias,and cardiac death in group B were significantly higher than those in group A(P0.05).LVEF in group B(49.97±7.21)% was much lower than that in group A(54.03±6.34)%(P0.05).Conclusion Abnormal increase of blood glucose and stress hormones levels at admission is associated with poor prognosis of AMI patients within 30 days after PCI.