应激性高血糖比值是前壁ST段抬高型心肌梗死患者院内发生心力衰竭的独立预测因素。
Stress hyperglycaemia ratio is an independent predictor of in-hospital heart failure among patients with anterior ST-segment elevation myocardial infarction.
作者信息
Alqahtani Saif Aboud M, Wani Javed Iqbal, Aziz Shahid, Durrani Humayoun Khan, Patel Ayyub Ali, Rangraze Imran, Mirdad Rasha Tarek, Alfayea Muad Ali, Shahrani Sara
机构信息
Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Prince Faisal bin Khalid Cardiac Centre, Abha, Saudi Arabia.
出版信息
BMC Cardiovasc Disord. 2024 Dec 28;24(1):751. doi: 10.1186/s12872-024-04362-4.
BACKGROUND
Stress hyperglycaemia ratio (SHR) has been reported to be independently and significantly associated with various adverse cardiovascular events as well as mortality. Moreover, in-hospital heart failure following acute myocardial infarction has been demonstrated to account for majority of all heart failure (HF) cases with anterior myocardial infarction showing higher rates of HF. However, the association between SHR and in-hospital HF following an anterior ST-elevation myocardial infarction (STEMI) has not been reported earlier. Therefore, the present study aimed at identifying the relationship between SHR and in-hospital HF post STEMI.
METHODS
In this retrospective study electronic health records of 512 patients who presented with anterior STEMI from 01 January 2022 to 31 January 2024 were analysed. Based on the development of in-hospital HF, the enrolled patients were stratified into two groups: Group I, comprising of 290 patients who developed in-hospital HF and Group II comprising of 222 patients who did not develop in-hospital HF. ROC and Multivariable logistic regression analyses were performed to assess the relationship between SHR and in-hospital HF.
RESULTS
The results revealed that SHR is a significant independent predictor of in-hospital HF (OR: 3.53; 95%CI: 2.02-6.15; p < 0.001). Apart from SHR, the results also identified age, nosocomial pneumonia, ventricular fibrillation, LVEF, and NT-pro-BNP levels as other independent predictors. ROC analysis showed that SHR independently had a moderate discriminative power with AUC: 0.683, 95% CI 0.605-0.762; p = 0.04, which was almost comparable to the combined predictive value of other independent risk factors (AUC: 0.726, 95% CI 0.677-0.784). Noticeably, combining SHR and other identified independent predictors demonstrated a significant predictive power (AUC: 0.813, 95% CI 0.757-0.881; p = 0.01).
CONCLUSION
SHR is an independent predictor for in-hospital HF in anterior wall STEMI patients.
背景
据报道，应激性高血糖比率（SHR）与各种不良心血管事件及死亡率独立且显著相关。此外，急性心肌梗死后的院内心力衰竭已被证明占所有心力衰竭（HF）病例的大多数，前壁心肌梗死的HF发生率更高。然而，此前尚未有关于SHR与前壁ST段抬高型心肌梗死（STEMI）后院内HF之间关联的报道。因此，本研究旨在确定SHR与STEMI后院内HF之间的关系。
方法
在这项回顾性研究中，分析了2022年1月1日至2024年1月31日期间出现前壁STEMI的512例患者的电子健康记录。根据院内HF的发生情况，将纳入的患者分为两组：第一组，包括290例发生院内HF的患者；第二组，包括222例未发生院内HF的患者。进行ROC和多变量逻辑回归分析以评估SHR与院内HF之间的关系。
结果
结果显示，SHR是院内HF的显著独立预测因子（比值比：3.53；95%置信区间：2.02 - 6.15；p < 0.001）。除SHR外，结果还确定年龄、医院获得性肺炎、心室颤动、左心室射血分数（LVEF）和N末端脑钠肽前体（NT-pro-BNP）水平为其他独立预测因子。ROC分析表明，SHR独立具有中等判别能力，曲线下面积（AUC）为0.683，95%置信区间为0.605 - 0.762；p = 0.04，这几乎与其他独立危险因素的联合预测价值（AUC：0.726，95%置信区间：0.677 - 0.784）相当。值得注意的是，将SHR与其他确定的独立预测因子相结合显示出显著的预测能力（AUC：0.813，95%置信区间：0.757 - 0.881；p = 0.01）。
结论
SHR是前壁STEMI患者院内HF的独立预测因子。
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