Admission Hyperglycemia is Associated with Global Registry of Acute Coronary Events Score and Complications Following Acute Myocardial Infarction During 1-Year Follow-Up
Admission Hyperglycemia is Associated with Global Registry of Acute Coronary Events Score and Complications Following Acute Myocardial Infarction During 1-Year Follow-Up
复制标题
DOI：
10.1177/00033197211039915
复制
发表时间：
2021-08
期刊：
影响因子：
2.8
通讯作者：
Yuhan Qin;Yong Qiao;Dong Wang;Chengchun Tang;G. Yan
中科院分区：
文献类型：
--
作者：
Yuhan Qin;Yong Qiao;Dong Wang;Chengchun Tang;G. Yan
我们探讨了入院时高血糖(AH)对急性冠状动脉事件全球登记(GRACE)危险评分和急性心肌梗死(AMI)患者1年随访期间主要不良心脑血管事件(MACCE)发生率的影响。在这项纳入1098例急性心肌梗死患者的回顾性观察研究中，高血糖定义为入院时血糖水平≥180 mg/dl。总体而言，在272名糖尿病患者和826名非糖尿病患者中，分别有158名和84名患者被诊断为AH。糖尿病患者入院时的血糖水平与GRACE评分密切相关。222例患者发生MACCE，AH患者MACCE发生率较高(28.1%)。多因素COX Logistic回归分析显示，AH是1年MACCEs的独立危险因素。亚组分析表明，在非糖尿病患者中，高血糖会增加MACCE的风险，但在糖尿病患者中不会。ROC分析显示，入院时血糖水平结合GRACE危险评分对MACCE的发生有一定的预测价值(OR=0.798，p<；.001)。在ST段抬高的心肌梗死患者中，AH与较高的GRACE危险评分密切相关。因此，急性心肌梗死后1年的随访中，急性心肌梗死是一个独立的危险因素，对MACCE有很高的预测价值。
We explored the effect of admission hyperglycemia (AH) on the Global Registry of Acute Coronary Events (GRACE) risk score and major adverse cardiovascular and cerebrovascular event (MACCE) incidence during 1-year follow-up in acute myocardial infarction (AMI) patients. In this retrospective observational study enrolling 1098 AMI patients, hyperglycemia was defined as blood glucose level ≥180 mg/dl at admission. Overall, 158 and 84 patients of 272 diabetic and 826 non-diabetic patients were diagnosed with AH, respectively. Glucose levels at admission were closely associated with the GRACE score in patients with/without diabetes. MACCEs occurred in 222 patients; patients with AH showed significantly higher MACCE incidence (28.1%). Multivariate Cox logistic regression analysis indicated that AH was an independent risk factor for 1-year MACCEs. Subgroup analysis demonstrated that hyperglycemia increases MACCE risk in non-diabetic patients but not in diabetic patients. The admission glucose level combined with GRACE risk score showed a certain predictive value for MACCE incidence according to ROC analysis (OR = 0.798, p < .001). AH was strongly associated with a higher GRACE risk score in ST-segment elevation myocardial infarction patients. Thus, AH was an independent risk factor and had a high predictive value for MACCE during 1-year follow-up after AMI.