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

Abstract

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.