Metabolic Dysfunction at the Culprit Lesion: The Triglyceride–Glucose Index as a Marker of Thrombus Burden and No-Reflow in STEMI
DOI:
https://doi.org/10.48047/m8ccr451Keywords:
Triglyceride–glucose index, ST-segment elevation myocardial infarction, intracoronary thrombus, no-reflow phenomenon, primary percutaneous coronary interventionAbstract
Background: Primary percutaneous coronary intervention (PCI) restores epicardial patency in most patients with ST-segment elevation myocardial infarction (STEMI), yet adequate tissue reperfusion is not assured. A large intracoronary thrombus can promote distal embolization, while microvascular obstruction may produce no-reflow despite an angiographically patent infarct-related artery. Both conditions are associated with greater myocardial injury and poorer clinical outcomes. Insulin resistance contributes toendothelial dysfunction, platelet hyperreactivity, inflammation, oxidative stress, impaired fibrinolysis, and microvascular injury
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References
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;39(2):119-77.
Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J Acute Cardiovasc Care. 2024;13(1):55-161.
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