León-Aliz Ebrey, Moreno-Martínez Francisco L, Pérez-Fernández Guillermo A, Vega-Fleites Luis F, Rabassa-López-Calleja Magda A
Servicio de Cardiología, Hospital Dr. Celestino Hernández Robau, Villa Clara, Cuba.
Unidad de Hemodinámica y Cardiología Intervencionista, Cardiocentro Ernesto Che Guevara, Villa Clara, Cuba.
Clin Investig Arterioscler. 2014 Jul-Aug;26(4):168-75. doi: 10.1016/j.arteri.2014.01.002. Epub 2014 Feb 22.
Blood glucose and white blood cell count on admission have demonstrated prognostic significance in patients with myocardial infarction; leuko-glycemic index, a recently proposed marker, still lacks enough knowledge about its value.
To evaluate the leuko-glycemic index as a prognostic marker in patients with ST-segment elevation myocardial infarction.
A retrospective study was carried out in 128 patients with ST-segment elevation myocardial infarction, who were admitted between January 2009 and October 2010 in the Intensive Care Unit of the Hospital Dr. Celestino Hernández Robau. Clinical and laboratory data were collected, including glucose and white blood cell count on admission, from which we calculated the leuko-glycemic index and we evaluated its prognostic value.
Patients who had a poor outcome such as death, major cardiac complications and failed-thrombolysis, showed higher values of leuko-glycemic index (P<.01), which was correlated with several variables such as Killip class, and heart rate on admission (P=.000). We obtained a cutoff point of 1.158, patients with higher values had 3 times higher probability of death and complications (odds ratio=3,0; IC 95%: 1,2-7,3; P=.005); so leuko-glycemic index was an independent predictor after multivariate analysis.
The leuko-glycemic index was associated with an increased occurrence of hospital complications, death and failed-thrombolysis; its pathological value was an independent predictor of in-hospital death and complications in the studied sample.
入院时的血糖和白细胞计数已证明对心肌梗死患者具有预后意义；白细胞-血糖指数作为一种最近提出的标志物，对其价值仍缺乏足够了解。
评估白细胞-血糖指数作为ST段抬高型心肌梗死患者预后标志物的价值。
对128例ST段抬高型心肌梗死患者进行回顾性研究，这些患者于2009年1月至2010年10月入住塞莱斯蒂诺·埃尔南德斯·罗鲍博士医院重症监护病房。收集临床和实验室数据，包括入院时的血糖和白细胞计数，据此计算白细胞-血糖指数并评估其预后价值。
出现死亡、严重心脏并发症和溶栓失败等不良结局的患者，白细胞-血糖指数值较高（P<0.01），该指数与Killip分级和入院时心率等多个变量相关（P=0.000）。我们得出的截断点为1.158，指数值较高的患者死亡和并发症发生概率高出3倍（优势比=3.0；95%置信区间：1.2-7.3；P=0.005）；因此，白细胞-血糖指数在多变量分析后是一个独立预测指标。
白细胞-血糖指数与医院并发症、死亡和溶栓失败发生率增加相关；在研究样本中，其病理值是院内死亡和并发症的独立预测指标。
