The stress hyperglycemia ratio improves the predictive ability of the GRACE score for in-hospital mortality in patients with acute myocardial infarction

被引：14

作者：

Chen, Qiang ^{[1
]}

Su, Hong ^{[1
]}

Yu, Xiuqiong ^{[1
]}

Chen, Yingzhong ^{[1
]}

Ding, Xunshi ^{[1
]}

Xiong, Bo ^{[1
]}

Wang, Chunbin ^{[1
]}

Xia, Long ^{[1
]}

Ye, Tao ^{[1
]}

Lan, Kai ^{[1
]}

Hou, Jun ^{[1
]}

Xiong, Shiqiang ^{[1
]}

Cai, Lin ^{[1
]}

机构：

[1] Southwest Jiaotong Univ, Peoples Hosp Chengdu 3, Affiliated Hosp, Chengdu Cardiovasc Dis Res Inst,Dept Cardiol, Chengdu 610014, Sichuan, Peoples R China

来源：

HELLENIC JOURNAL OF CARDIOLOGY | 2023年 / 70卷

基金：

中国国家自然科学基金;

关键词：

acute myocardial infarction; GRACE score; stress hyperglycemia ratio; admission blood glucose; in-hospital mortality; ACUTE CORONARY SYNDROMES; ADVERSE CARDIAC EVENTS; ST-SEGMENT ELEVATION; ADMISSION GLUCOSE; GLOBAL REGISTRY; BLOOD-GLUCOSE; RISK; IMPACT; INTERVENTION; INFLAMMATION;

D O I：

10.1016/j.hjc.2022.12.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The Global Registry of Acute Coronary Events (GRACE) score is a powerful tool used to predict in-hospital mortality after acute myocardial infarction (AMI) and does not include a glycometabolism-related index. We investigated whether the addition of the stress hyperglycemia ratio (SHR) provides incremental prognostic value in addition to the GRACE score. Methods: A retrospective cohort of 613 AMI patients was enrolled in the present analyses. The patients were stratified according to the primary endpoint (in-hospital mortality) and the tertiles of the SHR. Results: During hospitalization, 40 patients reached the primary endpoint, which was more frequently observed in patients with a higher SHR. The SHR, but not admission blood glucose (ABG), adjusted for the GRACE score independently predicted in-hospital mortality [odds ratio 2.5861; 95% confidence interval (CI), 1.3910-4.8080; P 1/4 0.0027]. The adjustment of the GRACE score by the SHR improved the predictive ability for in-hospital death (an increase in the C-statistic value from 0.787 to 0.814; net reclassification improvement, 0.6717, 95% CI 0.3665-0.977, P < 0.01; integrated discrimination improvement, 0.028, 95% CI 0.0066-0.0493, P 1/4 0.01028). The likelihood ratio test showed that the SHR significantly improved the prognostic models, including the GRACE score. Adding the SHR to the GRACE score presented a larger net benefit across the range of in-hospital mortality risk than the GRACE score alone. Conclusion: The SHR, but not the ABG, is an independent predictor of in-hospital mortality after AMI even after adjusting for the GRACE score. The SHR improves the predictability and clinical usefulness of prognostic models containing the GRACE score.(c) 2023 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：36 / 45

页数：10

共 44 条

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