The most serious type of all heart attacks is ST-elevated myocardial infarction (STEMI), which involves complete or near-complete blockage of a major coronary artery. Patients typically receive angioplasty plus a stent to open the blocked artery, but the artery later re-closes in about one-fourth of patients, a process known as restenosis. Diabetes is a well-known risk factor for cardiovascular disease; but it wasn’t known whether non-diabetic patients treated for an acute heart attack faced an increased risk for restenosis if their blood glucose levels were elevated on hospital admission.

In a study published September 16 in Diabetes Care, Gaetano Santulli, M.D., Ph.D., and colleagues evaluated 336 STEMI patients treated with angioplasty and stent implantation. At one-year follow-up, 6.5 percent of patients with normal blood sugar, 14 percent of those with high blood sugar but not diabetic, and 18.5 percent of diabetic patients with high blood sugar had been re-hospitalized for restenosis. The results were confirmed after adjusting for other factors known to influence the risk of restenosis after angioplasty. The study is the first to show that high blood sugar at hospital admission is a significant and independent risk factor for restenosis in non-diabetic STEMI patients.

Dr. Santulli is an associate professor of medicine and of molecular pharmacology at Einstein.