ST段抬高型心肌梗死患者接受经皮冠状动脉介入治疗时入院血糖与白蛋白比值与临床结局的关系
Association between admission-blood-glucose-to-albumin ratio and clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.
作者信息
Zhen Cien, Chen Wei, Chen Weikun, Fan Hualin, Lin Zijing, Zeng Lihuan, Lin Zehuo, He Weibin, Li Yu, Peng Shimin, Zeng Lin, Duan Chongyang, Tan Ning, Liu Yuanhui, He Pengcheng
机构信息
Department of Cardiology, School of Medicine, South China University of Technology, Guangzhou, China.
Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
出版信息
Front Cardiovasc Med. 2023 Sep 7;10:1132685. doi: 10.3389/fcvm.2023.1132685. eCollection 2023.
INTRODUCTION
It is unclear whether admission-blood-glucose-to-albumin ratio (AAR) predicts adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who are treated with percutaneous coronary intervention (PCI). Here, we performed a observational study to explore the predictive value of AAR on clinical outcomes.
METHODS
Patients diagnosed with STEMI who underwent PCI between January 2010 and February 2020 were enrolled in the study. The patients were classified into three groups according to AAR tertile. The primary outcome was in-hospital all-cause mortality, and the secondary outcomes were in-hospital major adverse cardiac events (MACEs), as well as all-cause mortality and MACEs during follow-up. Logistic regression, Kaplan-Meier analysis, and Cox proportional hazard regression were the primary analyses used to estimate outcomes.
RESULTS
Among the 3,224 enrolled patients, there were 130 cases of in-hospital all-cause mortality (3.9%) and 181 patients (5.4%) experienced MACEs. After adjustment for covariates, multivariate analysis demonstrated that an increase in AAR was associated with an increased risk of in-hospital all-cause mortality [adjusted odds ratio (OR): 2.72, 95% CI: 1.47-5.03, = 0.001] and MACEs (adjusted OR: 1.91, 95% CI: 1.18-3.10, = 0.009), as well as long-term all-cause mortality [adjusted hazard ratio (HR): 1.64, 95% CI: 1.19-2.28, = 0.003] and MACEs (adjusted HR: 1.58, 95% CI: 1.16-2.14, = 0.003). Receiver operating characteristic (ROC) curve analysis indicated that AAR was an accurate predictor of in-hospital all-cause mortality (AUC = 0.718, 95% CI: 0.675-0.761) and MACEs (AUC = 0.672, 95% CI: 0.631-0.712).
DISCUSSION
AAR is a novel and convenient independent predictor of all-cause mortality and MACEs, both in-hospital and long-term, for STEMI patients receiving PCI.
引言
入院时血糖与白蛋白比值（AAR）是否能预测接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者的不良临床结局尚不清楚。在此，我们进行了一项观察性研究，以探讨AAR对临床结局的预测价值。
方法
纳入2010年1月至2020年2月期间诊断为STEMI并接受PCI的患者。根据AAR三分位数将患者分为三组。主要结局是院内全因死亡率，次要结局是院内主要不良心脏事件（MACE）以及随访期间的全因死亡率和MACE。逻辑回归、Kaplan-Meier分析和Cox比例风险回归是用于估计结局的主要分析方法。
结果
在3224例纳入患者中，有130例院内全因死亡（3.9%），181例患者（5.4%）发生MACE。在对协变量进行调整后，多变量分析表明，AAR升高与院内全因死亡风险增加相关[调整后的优势比（OR）：2.72，95%置信区间（CI）：1.47-5.03，P = 0.001]以及MACE风险增加相关（调整后的OR：1.91，95% CI：1.18-3.10，P = 0.009），以及长期全因死亡风险增加[调整后的风险比（HR）：1.64，95% CI：1.19-2.28，P = 0.003]和MACE风险增加（调整后的HR：1.58，95% CI：1.16-2.14，P = 0.003）。受试者工作特征（ROC）曲线分析表明，AAR是院内全因死亡（AUC = 0.718，95% CI：0.675-0.761）和MACE（AUC = 0.672，95% CI：0.631-0.712）的准确预测指标。
讨论
对于接受PCI的STEMI患者，AAR是院内和长期全因死亡及MACE的一种新颖且便捷的独立预测指标。
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