Jiang Maoling, Chen Qiang, Feng Qiao, Peng Xiufen, Liu Juan, He Hui, Su Hong, Jia Dongyue, Tong Lin, Tian Jing, Xiong Shiqiang, Cai Lin
Department of Cardiology, Affiliated Hospital, Southwest Medical University, 646000 Luzhou, Sichuan, China.
Department of Cardiology, The Third People's Hospital of Chengdu, 610014 Chengdu, Sichuan, China.
Rev Cardiovasc Med. 2025 Apr 24;26(4):26567. doi: 10.31083/RCM26567. eCollection 2025 Apr.
Blood glucose and serum albumin can be biomarkers at admission since they are easily accessible and demonstrate correlations with cardiovascular diseases. The predictive ability of the admission blood glucose to albumin ratio (AAR) for long-term prognosis in patients with acute coronary syndrome (ACS) and its potential to elevate the predictive value of the Global Registry of Acute Coronary Events (GRACE) risk score in ACS patients post-percutaneous coronary intervention (PCI) remains unknown. Hence, this study aimed to investigate the incremental prognostic value of the AAR in patients with ACS undergoing PCI.
A rigorous development-validation approach was implemented to optimize the GRACE risk score, utilizing the AAR parameter in 1498 patients suffering from ACS after PCI at the Third People's Hospital of Chengdu, Sichuan, China.
Over a median of 31.25 (27.53, 35.10) months, the incidence of major adverse cardiac events (MACEs), defined as a composite outcome encompassing all-cause death, cardiac death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization, was higher in individuals with higher AARs. Thus, the AAR was an independent predictor of long-term prognosis in ACS patients undergoing PCI (HR, 1.145; 95% CI: 1.045-1.255; = 0.004). The integration of the AAR score with the GRACE risk score increased the C statistic from 0.717 (95% CI: 0.694-0.740) to 0.733 (95% CI: 0.690-0.776) ( < 0.01).
The AAR is an independent predictor of prognosis in ACS patients and significantly increased the predictive value of the GRACE risk score.
血糖和血清白蛋白在入院时可作为生物标志物，因为它们易于获取且与心血管疾病存在关联。急性冠状动脉综合征（ACS）患者入院时血糖与白蛋白比值（AAR）对长期预后的预测能力，及其提高经皮冠状动脉介入治疗（PCI）后ACS患者全球急性冠状动脉事件注册研究（GRACE）风险评分预测价值的潜力尚不清楚。因此，本研究旨在探讨AAR在接受PCI的ACS患者中的增量预后价值。
采用严格的开发 - 验证方法来优化GRACE风险评分，在中国四川成都第三人民医院对1498例PCI术后的ACS患者使用AAR参数。
在中位时间31.25（27.53，35.10）个月内，主要不良心脏事件（MACE）的发生率，即包括全因死亡、心源性死亡、非致命性心肌梗死、非致命性卒中以及计划外再次血运重建的复合结局，在AAR较高的个体中更高。因此，AAR是接受PCI的ACS患者长期预后的独立预测因子（HR，1.145；95%CI：1.045 - 1.255； = 0.004）。将AAR评分与GRACE风险评分相结合，C统计量从0.717（95%CI：0.694 - 0.740）提高到0.733（95%CI：0.690 - 0.776）（ < 0.01）。
AAR是ACS患者预后的独立预测因子，显著提高了GRACE风险评分的预测价值。
