Pu Jinfang, Zhang Hongxing, Wang Feng, Zhou Yanji, Liu Dajin, Wang Huawei, Shi Tao, Yang Sirui, Yang Fazhi, Chen Lixing
The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China.
Department of Pathogenic Biology and Immunology, Kunming Medical University, 650500 Kunming, Yunnan, China.
Rev Cardiovasc Med. 2025 Mar 19;26(3):26065. doi: 10.31083/RCM26065. eCollection 2025 Mar.
Systemic inflammation and glucose metabolism are strongly associated with survival in ST-elevation myocardial infarction (STEMI) patients. Therefore, we aimed to assess whether the glucose-to-lymphocyte ratio (GLR) could be used to predict the prognosis of STEMI patients who received emergency percutaneous coronary intervention (PCI) treatment.
The GLR was calculated as follows: GLR = glucose (mg/dL) / lymphocyte count (K/μL). Patients were divided into two groups according to the median GLR, with the low-GLR group (GLR <81) employed as the reference group. We used Cox proportional hazard regression analyses to determine the predictive value of clinical indicators. Kaplan‒Meier curves were used to plot survival curves for both groups. The receiver operating characteristic (ROC) curves were used to assess the predictive value of the GLR for the risk of all-cause mortality and cardiovascular mortality in STEMI patients. Meanwhile, to evaluate the predictive effectiveness of the models, we plotted the ROC curves for each model.
We retrospectively analyzed 1086 newly admitted patients with STEMI who underwent emergency PCI at the First Affiliated Hospital of Kunming Medical University from June 2018 to January 2023 (mean follow-up time, M ± standard deviation (SD): 1100.66 ± 539.76 days). The results showed that high GLR was associated with increased risks of all-cause mortality (hazard ratio (HR) = 2.530, 95% CI = 1.611-3.974, < 0.001) and cardiovascular mortality (HR = 3.859, 95% CI = 2.225-6.691, < 0.001). The optimal GLR threshold for predicting all-cause and cardiovascular death was 79.61 (K/μL), with a ROC for all-cause death of 0.678 (95% CI: 0.625-0.732, < 0.001), a sensitivity of 77.4%, a specificity of 51.9%, and a ROC for cardiovascular death of 0.716 (95% CI: 0.666-0.767, < 0.001), with a sensitivity of 88.4% and a specificity of 52.1%.
The GLR may potentially predict all-cause mortality and cardiovascular mortality in STEMI patients who received emergency PCI treatment. A high GLR was associated with a greater risk of all-cause mortality and cardiovascular mortality in STEMI patients.
全身炎症和葡萄糖代谢与ST段抬高型心肌梗死（STEMI）患者的生存率密切相关。因此，我们旨在评估血糖与淋巴细胞比值（GLR）是否可用于预测接受急诊经皮冠状动脉介入治疗（PCI）的STEMI患者的预后。
GLR的计算方法如下：GLR = 血糖（mg/dL）/淋巴细胞计数（K/μL）。根据GLR中位数将患者分为两组，低GLR组（GLR <81）作为参照组。我们采用Cox比例风险回归分析来确定临床指标的预测价值。采用Kaplan-Meier曲线绘制两组的生存曲线。采用受试者工作特征（ROC）曲线评估GLR对STEMI患者全因死亡风险和心血管死亡风险的预测价值。同时，为评估模型的预测效能，我们绘制了每个模型的ROC曲线。
我们回顾性分析了2018年6月至2023年1月在昆明医科大学第一附属医院接受急诊PCI的1086例新入院STEMI患者（平均随访时间，M±标准差（SD）：1100.66±539.76天）。结果显示，高GLR与全因死亡风险增加（风险比（HR）=2.530，95%置信区间（CI）=1.611 - 3.974，P<0.001）和心血管死亡风险增加（HR = 3.859，95%CI = 2.225 - 6.691，P<0.001）相关。预测全因死亡和心血管死亡的最佳GLR阈值为79.61（K/μL），全因死亡的ROC为0.678（95%CI：0.625 - 0.732，P<0.001），灵敏度为77.4%，特异度为51.9%，心血管死亡的ROC为0.716（95%CI：0.666 - 0.767，P<0.001），灵敏度为88.4%，特异度为52.1%。
GLR可能预测接受急诊PCI治疗的STEMI患者的全因死亡和心血管死亡。高GLR与STEMI患者全因死亡和心血管死亡风险增加相关。
