Single prognostic cut-off value for admission glycemia in acute myocardial infarction has been used although high-risk stems from hyperglycemia as well as from hypoglycemia (a narrative review)

Koraćević, Goran; Mićić, Slađana; Stojanović, Milovan; Tomasević, M; Kostić, Tomislav; Koraćević, Maja; Jankovic, Irena

doi:10.1016/j.pcd.2020.09.004

Cited by 8 publications

(6 citation statements)

References 106 publications

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“…Cardiovascular complications are the main cause of death in diabetic patients [ 7 , 8 ]. Previous studies showed that admission hyperglycemia was an independent risk factor for poor prognosis of ACS patients, irrespective of whether or not they had diabetes [ 9 , 10 ]. Pasquale first showed that hyperglycemia was associated with adverse outcomes and increased risk of restenosis in ST-elevation myocardial infarction patients without diabetes mellitus [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Admission Hyperglycemia on Short-Term Prognosis of Patients with Non-ST Elevation Acute Coronary Syndrome without Diabetes Mellitus

Liu

Xing

et al. 2021

Journal of Diabetes Research

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Objective. To evaluate the effect of admission hyperglycemia on the short-term prognosis of patients with non-ST elevation acute coronary syndrome (NSTE-ACS) without diabetes mellitus. Methods. The clinical data of 498 patients with NSTE-ACS admitted to the Department of Cardiology of the First Affiliated Hospital of Henan University of Science and Technology between March 2018 and November 2020 were analyzed. Based on the blood glucose (BG) level at admission, patients were divided into three groups: A ( BG < 7.8 mmol/L), B ( 7.8 mmol / L ≤ BG < 11.1 mmol / L ), and C ( BG ≥ 11.1 mmol/L). The clinical data of the three groups were compared. Results. There was no significant difference between the three groups in terms of age, sex, hypertension, hyperlipidemia, smoking, and history of myocardial infarction ( p > 0.05 ). However, there were significant differences in the incidences of multivessel disease, renal insufficiency, pump failure, and emergency percutaneous coronary intervention, and levels of high-sensitivity C-reactive protein, cardiac troponin T, and creatine kinase isoenzyme MB among the three groups ( p < 0.05 for all). The incidences of severe pump failure, malignant arrhythmias, and death were significantly higher in groups B and C compared to group A ( p < 0.05 ). Additionally, the incidences of severe pump failure, malignant arrhythmias, and death were significantly higher in group C compared to group B ( p < 0.05 ). Multivariate logistic regression analysis showed that hyperglycemia, renal insufficiency, Killip grade III/IV, and age were risk factors of in-hospital death. Conclusion. Hyperglycemia at admission is a risk factor for adverse in-hospital clinical outcomes in patients with NSTE-ACS.

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Section: Discussionmentioning

confidence: 99%

Effect of Admission Hyperglycemia on Short-Term Prognosis of Patients with Non-ST Elevation Acute Coronary Syndrome without Diabetes Mellitus

Liu

Xing

et al. 2021

Journal of Diabetes Research

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“…existed or not, which affected the predictive effect of admission serum glucose to a certain extent, especially in patients with AMI and diabetes. 9 Hence, this study sought to investigate the significant cut-off value of admission blood glucose for predicting adverse events in patients with AMI with or without diabetes, and to provide clinicians with a trigger point for glucose-lowering therapy.…”

Section: Original Researchmentioning

confidence: 99%

“…The mechanisms of glucose metabolism are different between patients with diabetes and without diabetes, so the serum glucose cut-off value at admission for predicting mortality should be unequal 8. Nevertheless, most studies used the same prognostic threshold whether diabetes existed or not, which affected the predictive effect of admission serum glucose to a certain extent, especially in patients with AMI and diabetes 9…”

Section: Introductionmentioning

confidence: 99%

Relationship between hyperglycaemia at admission and prognosis in patients with acute myocardial infarction: a retrospective cohort study

Liu

Qian

Yan

et al. 2022

Postgraduate Medical Journal

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BackgroundThe optimal threshold of hyperglycaemia at admission for identifying high-risk individuals in patients with acute myocardial infarction (AMI) and its impact on clinical prognosis are still unclear.MethodsWe retrospectively reviewed 2027 patients with AMI admitted from June 2001 to December 2012 in the ‘Medical Information Mart for Intensive Care III’ database. The significant cut-off values of admission blood glucose (Glucose_0) for predicting hospital mortality in patients with AMI with and without diabetes were obtained from the receiver operating characteristic (ROC) curve, then patients were assigned to hyperglycaemia and non-hyperglycaemia groups based on corresponding cut-off values. The primary endpoints were the hospital and 1-year mortality.ResultsAmong 2027 patients, death occurred in 311 patients (15.3%). According to the ROC curve, the significant cut-off values of Glucose_0 to predict hospital mortality were 224.5 and 139.5 mg/dL in patients with diabetes and without diabetes, respectively. The crude hospital and 1-year mortality of the hyperglycaemia subgroup were higher than the corresponding non-hyperglycaemia group (p< 0.01). After adjustment, regardless of the state of diabetes, hyperglycaemia at admission was related to significantly increased hospital mortality in patients with AMI. For patients with AMI without diabetes, hyperglycaemia at admission was positively correlated with the increase of 1-year mortality (HR, 1.47; 95% CI 1.18 to 1.82; p=0.001). Nevertheless, this trend disappeared in those with diabetes (HR, 1.35; 95% CI 0.93 to 1.95; p=0.113).ConclusionHyperglycaemia at admission was an independent predictor for mortality during hospitalisation and at 1-year in patients with AMI, especially in patients without diabetes.

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“…The increase of FBG is correlated with Gensini score [8,9].Previous studies have shown a signi cant positive correlation between fasting glucose and gensini scores, con rming even in the non-diabetic range [10][11][12][13].It has been found in the past that there is a positive linear correlation between blood glucose and GENSINI score. Only the in uence of blood glucose on GENSINI is considered, without considering the in uence of other factors such as uric acid, creatinine and age on GENSINI.Previous meta-analyses and the original article used a single truncation to distinguish high-risk hyperglycemia [14], however,both hypoglycemia and hyperglycemia are high-risk factors for AMI.…”

Section: Introductionmentioning

confidence: 99%

U-shaped relationship between fasting blood glucose concentration and gensini sore analysis in STEMI patients

Zhong

2023

Preprint

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Background: An association between fasting blood glucose (FBG) and gensini scores has been reported. However, no studies have investigated the relationship between ST elevation myocardial infarction and FBG. The purpose of this study was to investigate the association between FBG and coronary artery disease severity score (Gensini score) in patients with ST-segment elevation (STEMI) myocardial infarction. Methods: In a retrospective analysis of 464 enrolled patients, we used minimum absolute contraction and selection operator (lasso) regression analysis to screen for covariates; In multiple regression analyses, we used gensini scores as the dependent variable, glucose as the independent variable, Fasting blood glucose was divided into hypoglycemic group 5.30mmol/L (2.69-6.15), medium glycemic group 7.11mmol/L (6.19-8.61) and hyperglycemic group 10.70mmol/L (8.64-14.81)，and selected variables as covariates to adjust and observe the true association between glucose and gensini scores. Considering that there is not necessarily a linear relationship between blood glucose and Guernsini score in the real world, we used curve fitting to observe the changing trend of blood glucose and Guernsini score. Results: When confounding factors are not adjusted, The gensini scores in the medium-glycemic and high-glycemic groups had significant clinical significance (the medium-glycemic group, 95%CI: -140162--0.213, P=0.044; Hyperglycemia group, 95%CI: 5.295-19.221, P=0.0006;) The relationship between fasting blood glucose and Guernsini score is U-shaped but non-linear. Using minimum absolute contraction and selection operator (LASSO) regression to select variables, Variables included neutrophils, hemoglobin, platelets, albumin, low-density lipoprotein, D-dimer, urea nitrogen, glucose, white blood cells, systolic blood pressure, heart rate, age, dm, culprit vessel, history of myocardial infarction, Killip grade, number of stents, creatinine, uric acid, total cholesterol,CTNI, CKMB, left ventricular end-diastolic diameter, left atrial diameter. After adjusting for confounder factors, only the hyperglycemic group had significant clinical significance in Gensini score (95%CI: -16.95--2.71, P=0.015). Curve fitting analysis showed that fasting glucose and Gensini score presented a U-shaped but non-linear relationship in patients diagnosed with or without diabetes. Conclusions: The severity of coronary stenosis in patients with ST-segment elevation myocardial infarction is influenced by either excessively high or excessively low fasting glucose concentration,Whether people with or without diabetes.

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Single prognostic cut-off value for admission glycemia in acute myocardial infarction has been used although high-risk stems from hyperglycemia as well as from hypoglycemia (a narrative review)

Cited by 8 publications

References 106 publications

Effect of Admission Hyperglycemia on Short-Term Prognosis of Patients with Non-ST Elevation Acute Coronary Syndrome without Diabetes Mellitus

Effect of Admission Hyperglycemia on Short-Term Prognosis of Patients with Non-ST Elevation Acute Coronary Syndrome without Diabetes Mellitus

Relationship between hyperglycaemia at admission and prognosis in patients with acute myocardial infarction: a retrospective cohort study

U-shaped relationship between fasting blood glucose concentration and gensini sore analysis in STEMI patients

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