Value of glycemic dispersion index in predicting major adverse cardiovascular events in diabetic patients with concomitant acute coronary syndrome

Abstract

Objective: This investigation aims to assess the predictive value of the glycemic dispersion index (GDI), calculated by incorporating glycated hemoglobin, fasting plasma glucose, and 2-hour postprandial plasma glucose, in predicting major adverse cardiovascular events (MACE) within a 12-month timeframe for diabetic patients with concomitant acute coronary syndrome (ACS). Methods A total of 3261 diabetic patients diagnosed with ACS were selected from the Department of Cardiology, the Sixth Affiliated Hospital of Kunming Medical University, between January 2016 and July 2022. A thorough screening process was conducted, resulting in the inclusion of 512 patients based on the predefined exclusion criteria. Comprehensive clinical data and laboratory examination indicators were collected for all included patients. Subsequently, a follow-up was carried out for 12 months, with the last follow-up being concluded on July 31, 2023. During this period, the occurrence of MACE was meticulously recorded for each enrolled patient. Based on the GDI calculated for the enrolled patients, they were divided into quartile groups. A comparative analysis was performed to evaluate the clinical data and laboratory indicators among these groups. Additionally, the incidence of MACE in each quartile group was calculated. To further identify the risk factors associated with MACE in diabetic patients with concomitant ACS, COX proportional hazards regression analysis and Kaplan-Meier survival analysis were conducted. Finally, the cumulative risk of MACE over time was compared among the different study groups. Results The patients included in the study were sorted into four groups, Q1, Q2, Q3, and Q4, according to their GDI levels, from lowest to highest. The respective proportions of MACE in the Q1 to Q4 groups were 10.16%, 12.50%, 15.63%, and 16.41%. GDI, STEMI, TC, TG, LDL, and hs-CRP independently predicted the hazards for MACE in diabetic individuals with ACS. The cumulative risk of MACE over time was considerably more significant in those with a GDI > 4.21 than those with a GDI ≤ 4.21. Conclusion The elevated GDI is correlated with an augmented risk of MACE in diabetic patients with concomitant ACS, thereby serving as an early indicator for assessing the unfavorable clinical prognosis of patients.