Short Term Effect of Primary Percutaneous Coronary Intervention on Left Ventricular Diastolic Function in Diabetic Patients

Background: Diabetes mellitus (DM) is associated with microvascular dysfunction and myocardial stiffness, which may impair post-reperfusion recovery following ST-segment elevation myocardial infarction (STEMI). While primary percutaneous coronary intervention (PCI) improves systolic outcomes, its short-term impact on left ventricular (LV) diastolic function in diabetic patients remains uncertain.
Objective: To evaluate the short-term effect of primary PCI on LV diastolic function in diabetic versus non-diabetic patients presenting with acute STEMI.
Patients and Methods: A prospective cohort study included 100 STEMI patients undergoing primary PCI at Tanta University and Nasser Institute Hospitals between July 2023 and July 2024. Patients were divided into two equal groups: diabetics and non-diabetics. Comprehensive clinical, laboratory, and echocardiographic assessments were performed before PCI and at three-month follow-up, including E/A ratio, E/e′ ratio, isovolumic relaxation time (IVRT), deceleration time (DT), and diastolic dysfunction (DD) grade.
Results: Diabetic patients were older (61.9 ± 6.2 vs. 54.6 ± 5.7 years, p<0.001) and had higher BMI, heart rate, and blood pressure. After three months, both groups showed significant improvements in LV systolic function (EF: from 49.9 ± 7.3 to 55.2 ± 7.2% in diabetics, and from 51.3 ± 4.0 to 57.0 ± 3.5% in non-diabetics; p<0.001 each). Diastolic indices changed significantly within groups (E/A decreased, E/e′, IVRT, and DT increased; p<0.001), but intergroup differences were non-significant. DD Grade III emerged in 22% of diabetics and 12% of non-diabetics (p=0.39).
Conclusion: Primary PCI improved LV systolic function in both diabetic and non-diabetic STEMI patients; however, early diastolic recovery remained limited, with comparable short-term outcomes between groups.