Li Yang, Jiang Jingyuan, Xie Nan, Zhang Wei
Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University Chengdu 610041, Sichuan, China.
Disaster Medical Center, Sichuan University Chengdu 610041, Sichuan, China.
Am J Transl Res. 2025 Apr 15;17(4):3179-3188. doi: 10.62347/AQXW7292. eCollection 2025.
To investigate the predictive value of blood glucose level in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome (ACS) concerning the degree of coronary artery disease and major adverse cardiovascular events (MACE).
A retrospective study was conducted on 104 T2DM patients with ACS who visited West China Hospital, Sichuan University, from August 2020 to March 2024. Based on the Gensini score, patients were categorized into mild (0-30 points), moderate (31-59 points), and severe (≥60 points) groups. Additionally, patients were divided into MACE and non-MACE groups based on the occurrence of MACE. General information, blood glucose levels, and coronary angiography results were collected, along with six-month follow-up data. The predictive value of blood glucose levels for the severity of coronary artery disease and cardiovascular adverse events was analyzed using receiver operating characteristic (ROC) curves.
There were significant differences in the levels of glycosylated serum protein (GSP), insulin-like growth factor-1 (IGF-1), and the triglyceride-glucose (TyG) index among patients with varying degrees of coronary artery disease (<0.05), with levels increasing in line with disease severity. The MACE group exhibited generally higher levels of GSP, IGF-1, and TyG compared to the non-MACE group (<0.05). ROC curve analysis revealed that the area under the curve (AUC) for GSP, IGF-1, and TyG for predicting severe coronary artery disease were 0.861, 0.936, and 0.896, respectively, and for predicting MACE occurrence were 0.738, 0.814, and 0.710, respectively (<0.05).
Blood glucose levels in T2DM patients with ACS have predictive value for both the severity of coronary artery disease and the occurrence of MACE. Measurement of GSP, IGF-1, and TyG is clinically significant for assessing prognosis and developing treatment strategies.
探讨2型糖尿病(T2DM)合并急性冠状动脉综合征(ACS)患者血糖水平对冠状动脉疾病程度及主要不良心血管事件(MACE)的预测价值。
对2020年8月至2024年3月期间就诊于四川大学华西医院的104例T2DM合并ACS患者进行回顾性研究。根据Gensini评分,将患者分为轻度(0 - 30分)、中度(31 - 59分)和重度(≥60分)组。此外,根据MACE的发生情况将患者分为MACE组和非MACE组。收集患者的一般信息、血糖水平、冠状动脉造影结果以及六个月的随访数据。采用受试者工作特征(ROC)曲线分析血糖水平对冠状动脉疾病严重程度和心血管不良事件的预测价值。
不同程度冠状动脉疾病患者的糖化血清蛋白(GSP)、胰岛素样生长因子-1(IGF-1)和甘油三酯-葡萄糖(TyG)指数水平存在显著差异(<0.05),且水平随疾病严重程度增加而升高。与非MACE组相比,MACE组的GSP、IGF-1和TyG水平总体较高(<0.05)。ROC曲线分析显示,GSP、IGF-1和TyG预测重度冠状动脉疾病的曲线下面积(AUC)分别为0.861、0.936和0.896,预测MACE发生的AUC分别为0.738、0.814和0.710(<0.05)。
T2DM合并ACS患者的血糖水平对冠状动脉疾病严重程度和MACE的发生均具有预测价值。检测GSP、IGF-1和TyG对评估预后及制定治疗策略具有临床意义。