Mesri Alamdari Naimeh, Lotfi Yagin Neda, Ghaffari Samad, Roshanravan Neda, Zarrintan Anita, Mobbaseri Majid
Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Sci Rep. 2025 Jul 29;15(1):27682. doi: 10.1038/s41598-025-13032-0.
The effects of hyperglycemia on the prognosis of MI patients remain uncertain. This investigation evaluates the prognostic significance of hyperglycemia upon hospital admission in patients with ST-Elevation Myocardial Infarction and assesses how diabetes mellitus (DM) affects its prognostic relevance. This cross-sectional study examined data from 334 patients diagnosed with ST-segment elevation acute coronary syndrome, obtained from the Persian Cardiovascular Disease Registry. The study assessed hospital and one-year mortality as primary outcomes. Furthermore, cut-off points for blood glucose level on admission were determined and the predictive value of these cut-off values was analyzed using logistic regression analysis. In-hospital and one-year mortality rates were 22.1% and 26% for diabetic patients, and 20.2% and 24.1% for non-diabetic patients, with no substantial discrepancy between the groups (P = 0.607, P = 0.401). ROC curve analysis determined the admission blood glucose cut-off for predicting hospital mortality at 214 mg/dl in patients with diabetes (AUC = 0.66) and 148 mg/dl in patients without diabetes (AUC = 0.71). Blood glucose values was an independent factors related to in-hospital mortality, with odds ratios of 3.78 (95% CI 1.33-10.68, P = 0.012) for diabetics and 3.07 (95% CI 1.25-7.51, P = 0.014) for non-diabetics. Additionally, heightened admission glucose was correlated with greater mortality in one year in patients affected with MI irrespective of diabetes status. Blood glucose levels at admission independently predicted increased risk of mortality both during hospitalization and at one-year follow-up in patients with MI, with a notable effect on non-diabetic patients.
高血糖对心肌梗死(MI)患者预后的影响仍不确定。本研究评估了ST段抬高型心肌梗死患者入院时高血糖的预后意义,并评估糖尿病(DM)如何影响其预后相关性。这项横断面研究检查了从波斯心血管疾病登记处获得的334例诊断为ST段抬高型急性冠状动脉综合征患者的数据。该研究将住院和一年死亡率作为主要结局进行评估。此外,确定了入院时血糖水平的截断点,并使用逻辑回归分析分析了这些截断值的预测价值。糖尿病患者的住院死亡率和一年死亡率分别为22.1%和26%,非糖尿病患者分别为20.2%和24.1%,两组之间无显著差异(P = 0.607,P = 0.401)。ROC曲线分析确定,糖尿病患者预测住院死亡率的入院血糖截断值为214 mg/dl(AUC = 0.66),非糖尿病患者为148 mg/dl(AUC = 0.71)。血糖值是与住院死亡率相关的独立因素,糖尿病患者的比值比为3.78(95% CI 1.33 - 10.68,P = 0.012),非糖尿病患者为3.07(95% CI 1.25 - 7.51,P = 0.014)。此外,无论糖尿病状态如何,MI患者入院时血糖升高与一年后更高的死亡率相关。入院时的血糖水平独立预测了MI患者住院期间和一年随访期间死亡风险的增加,对非糖尿病患者的影响尤为显著。