Association between hemoglobin glycation index and adverse outcomes in critically ill patients with myocardial infarction: A retrospective cohort study

Background and aim: The prognosis of critically ill patients with myocardial infarction (MI) is associated with metabolic disturbances. The hemoglobin glycation index (HGI), a marker of glycemic variability, has been linked to adverse outcomes in critically ill populations. This study aimed to explore the relationship between HGI and adverse outcomes in critically ill MI patients. Methods and results: This retrospective cohort study used data from the MIMIC-IV database, focusing on critically ill MI patients. Linear regression was applied to model the relationship between glucose and HbA1c, from which HGI values were calculated. Patients were grouped into quartiles based on HGI. Primary outcomes included 30-day, 180-day, and 365-day all-cause mortality. Kaplan-Meier survival analysis, logistic regression, Cox proportional hazards models, and restricted cubic spline (RCS) analysis were employed to assess the relationship between HGI and adverse outcomes. A total of 2480 patients were included. Lower HGI was associated with significantly increased risks of 30-day, 180-day, 365-day, and hospital all-cause mortality. RCS analysis revealed an inverse J-shaped relationship between HGI and mortality risk. Conclusions: Low HGI in critically ill MI patients is significantly associated with higher all-cause mortality, highlighting its potential as a prognostic marker for early risk stratification and management optimization.