Yeoree Yang1, Tae-Hoon Kim2, Kun-Ho Yoon1, Wook Sung Chung2, Youngkeun Ahn3, Myung-Ho Jeong3, Ki-Bae Seung2, Seung-Hwan Lee4, Kiyuk Chang5. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University, Gwangju, Republic of Korea. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: hwanx2@catholic.ac.kr. 5. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: kiyuk@catholic.ac.kr.
Abstract
BACKGROUND: We aimed to investigate the outcome-predicting value of a novel index of stress hyperglycemia in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI). METHODS: This was a retrospective observational study. Four-thousand-three-hundred-sixty-two subjects from the COACT registry were used to estimate the risk of major adverse cardiovascular and cerebrovascular events (MACCE), which are defined as composites of all-cause death, non-fatal myocardial infarction (MI) and non-fatal stroke. The stress hyperglycemia ratio (SHR) was calculated by dividing the random serum glucose at admission with the estimated average glucose derived from HbA1c. RESULTS: Over a median follow-up of 2.5years, 344 (7.9%), 43 (1.0%), and 89 (2.0%) cases of death, non-fatal MI, and non-fatal stroke occurred, respectively. Compared with the subjects in the lower three quartiles of SHR, the HR (95% CI) for the highest SHR quartile (Q4) group for MACCE was 1.31 (1.05, 1.64) in the total population and 1.45 (1.02, 2.06) in the non-diabetic population after adjusting for potential covariables. The risk of MACCE in the SHR Q4 group was significantly higher in patients presenting with ST-elevation MI (STEMI), which was not the case for patients presenting with other CAD types. The prognostic impact of SHR was more prominent for the 30-day MACCE. Similar results were observed in another cohort consisting of patients who only presented with acute MI. CONCLUSIONS: SHR is a useful predictive marker of MACCE after PCI, especially in non-diabetic patients with STEMI, which could be utilized to identify high-risk patients for adverse outcomes.
BACKGROUND: We aimed to investigate the outcome-predicting value of a novel index of stress hyperglycemia in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI). METHODS: This was a retrospective observational study. Four-thousand-three-hundred-sixty-two subjects from the COACT registry were used to estimate the risk of major adverse cardiovascular and cerebrovascular events (MACCE), which are defined as composites of all-cause death, non-fatal myocardial infarction (MI) and non-fatal stroke. The stress hyperglycemia ratio (SHR) was calculated by dividing the random serum glucose at admission with the estimated average glucose derived from HbA1c. RESULTS: Over a median follow-up of 2.5years, 344 (7.9%), 43 (1.0%), and 89 (2.0%) cases of death, non-fatal MI, and non-fatal stroke occurred, respectively. Compared with the subjects in the lower three quartiles of SHR, the HR (95% CI) for the highest SHR quartile (Q4) group for MACCE was 1.31 (1.05, 1.64) in the total population and 1.45 (1.02, 2.06) in the non-diabetic population after adjusting for potential covariables. The risk of MACCE in the SHR Q4 group was significantly higher in patients presenting with ST-elevation MI (STEMI), which was not the case for patients presenting with other CAD types. The prognostic impact of SHR was more prominent for the 30-day MACCE. Similar results were observed in another cohort consisting of patients who only presented with acute MI. CONCLUSIONS: SHR is a useful predictive marker of MACCE after PCI, especially in non-diabeticpatients with STEMI, which could be utilized to identify high-risk patients for adverse outcomes.
Authors: Andrea Fabbri; Giulio Marchesini; Barbara Benazzi; Alice Morelli; Danilo Montesi; Cesare Bini; Stefano Giovanni Rizzo Journal: Crit Care Explor Date: 2020-07-15
Authors: Tien F Lee; Morton G Burt; Leonie K Heilbronn; Arduino A Mangoni; Vincent W Wong; Mark McLean; N Wah Cheung Journal: Cardiovasc Diabetol Date: 2017-12-12 Impact factor: 9.951