Work

Predictive value of glucose coefficient of variation for in-hospital mortality in acute myocardial infarction patients undergoing PCI: Insights from the MIMIC-IV database

Year: 2024

Type: article

Abstract: Background: Acute myocardial infarction (AMI) carries a high short-term risk of death, even after percutaneous coronary intervention (PCI). Glucose variability (GV), measured by the glucose coefficient of variation (GluCV), is a potential risk factor for adverse outcomes. This study investigates GluCV's predictive value for in-hospital mortality in AMI patients undergoing PCI. Method: This study involved 2325 AMI patients who were admitted to the ICU and underwent PCI from the MIMIC-IV database. Patients were categorized into quartiles based on GluCV: <0.13, 0.13-0.20, 0.20-0.29, and ≥0.29. Multivariable logistic regression and Restricted cubic spline (RCS) analysis were employed to analyze the relationship between GluCV and in-hospital mortality. Mediation analysis was used to evaluate the role of GluCV in the relationship between disease complexity and severity. Results: Among the 2325 patients, 203 (8.7 %) died during hospitalization. Higher GluCV was associated with increased in-hospital mortality. Adjusted odds ratios for mortality were 1.35 (95 % CI: 0.71-2.55), 1.91 (95 % CI: 1.04-3.51), and 3.32 (95 % CI: 1.83-6.02) for the second, third, and fourth groups, respectively. RCS analysis indicated a linear relationship between Log GluCV and mortality risk, with each 1 SD increase in Log GluCV associated with a 1.70-fold increase in mortality. Subgroup analysis showed a stronger relationship between GluCV and mortality in patients younger than 70. Mediation analysis indicated that GluCV partially mediates the effect of comorbidities on organ dysfunction. Conclusions: GluCV is an important predictor of in-hospital mortality in AMI patients undergoing PCI. Managing GV to minimize fluctuations may improve patient prognosis.

Source: International Journal of Cardiology Cardiovascular Risk and Prevention

DOI: 10.1016/j.ijcrp.2024.200347

Authors: Zixuan Zhang, Mengmeng Ji, Qingqing Zhao, Luying Jiang, Shilang Fan, Houjuan Zuo

Institutions: Shihezi University, Tongji Hospital, Huazhong University of Science and Technology, Wuhan University of Science and Technology

Language: English

Topic: Hyperglycemia and glycemic control in critically ill and hospitalized patients

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,800