Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12933-021-01395-3
Title: Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients
Authors: Sia, Ching-Hui 
Chan, Mervyn Huan-Hao 
Zheng, Huili 
Ko, Junsuk
Ho, Andrew Fu-Wah 
Chong, Jun
Foo, David
Foo, Ling-Li
Lim, Patrick Zhan-Yun
Liew, Boon Wah 
Chai, Ping 
Yeo, Tiong-Cheng 
Tan, Huay-Cheem 
Chua, Terrance 
Chan, Mark Yan-Yee 
Tan, Jack Wei Chieh 
Bulluck, Heerajnarain
Hausenloy, Derek J 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Endocrinology & Metabolism
Cardiovascular System & Cardiology
ST-SEGMENT ELEVATION
CARBOHYDRATE-METABOLISM
RELATIVE HYPERGLYCEMIA
TASK-FORCE
ASSOCIATION
ADMISSION
MANAGEMENT
INFUSION
CURVES
INDEX
Issue Date: 19-Oct-2021
Publisher: BMC
Citation: Sia, Ching-Hui, Chan, Mervyn Huan-Hao, Zheng, Huili, Ko, Junsuk, Ho, Andrew Fu-Wah, Chong, Jun, Foo, David, Foo, Ling-Li, Lim, Patrick Zhan-Yun, Liew, Boon Wah, Chai, Ping, Yeo, Tiong-Cheng, Tan, Huay-Cheem, Chua, Terrance, Chan, Mark Yan-Yee, Tan, Jack Wei Chieh, Bulluck, Heerajnarain, Hausenloy, Derek J (2021-10-19). Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients. CARDIOVASCULAR DIABETOLOGY 20 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s12933-021-01395-3
Abstract: Background: Stress-induced hyperglycaemia at time of hospital admission has been linked to worse prognosis following acute myocardial infarction (AMI). In addition to glucose, other glucose-related indices, such as HbA1c, glucose-HbA1c ratio (GHR), and stress-hyperglycaemia ratio (SHR) are potential predictors of clinical outcomes following AMI. However, the optimal blood glucose, HbA1c, GHR, and SHR cut-off values for predicting adverse outcomes post-AMI are unknown. As such, we determined the optimal blood glucose, HbA1c, GHR, and SHR cut-off values for predicting 1-year all cause mortality in diabetic and non-diabetic ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) patients. Methods: We undertook a national, registry-based study of patients with AMI from January 2008 to December 2015. We determined the optimal blood glucose, HbA1c, GHR, and SHR cut-off values using the Youden’s formula for 1-year all-cause mortality. We subsequently analyzed the sensitivity, specificity, positive and negative predictive values of the cut-off values in the diabetic and non-diabetic subgroups, stratified by the type of AMI. Results: There were 5841 STEMI and 4105 NSTEMI in the study. In STEMI patients, glucose, GHR, and SHR were independent predictors of 1-year all-cause mortality [glucose: OR 2.19 (95% CI 1.74–2.76); GHR: OR 2.28 (95% CI 1.80–2.89); SHR: OR 2.20 (95% CI 1.73–2.79)]. However, in NSTEMI patients, glucose and HbA1c were independently associated with 1-year all-cause mortality [glucose: OR 1.38 (95% CI 1.01–1.90); HbA1c: OR 2.11 (95% CI 1.15–3.88)]. In diabetic STEMI patients, SHR performed the best in terms of area-under-the-curve (AUC) analysis (glucose: AUC 63.3%, 95% CI 59.5–67.2; GHR 68.8% 95% CI 64.8–72.8; SHR: AUC 69.3%, 95% CI 65.4–73.2). However, in non-diabetic STEMI patients, glucose, GHR, and SHR performed equally well (glucose: AUC 72.0%, 95% CI 67.7–76.3; GHR 71.9% 95% CI 67.7–76.2; SHR: AUC 71.7%, 95% CI 67.4–76.0). In NSTEMI patients, glucose performed better than HbA1c for both diabetic and non-diabetic patients in AUC analysis (For diabetic, glucose: AUC 52.8%, 95% CI 48.1–57.6; HbA1c: AUC 42.5%, 95% CI 37.6–47. For non-diabetic, glucose: AUC 62.0%, 95% CI 54.1–70.0; HbA1c: AUC 51.1%, 95% CI 43.3–58.9). The optimal cut-off values for glucose, GHR, and SHR in STEMI patients were 15.0 mmol/L, 2.11, and 1.68 for diabetic and 10.6 mmol/L, 1.72, and 1.51 for non-diabetic patients respectively. For NSTEMI patients, the optimal glucose values were 10.7 mmol/L for diabetic and 8.1 mmol/L for non-diabetic patients. Conclusions: SHR was the most consistent independent predictor of 1-year all-cause mortality in both diabetic and non-diabetic STEMI, whereas glucose was the best predictor in NSTEMI patients.
Source Title: CARDIOVASCULAR DIABETOLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/205735
ISSN: 14752840
DOI: 10.1186/s12933-021-01395-3
Appears in Collections:Elements
Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients..pdf1.15 MBAdobe PDF

OPEN

PublishedView/Download

SCOPUSTM   
Citations

2
checked on May 14, 2022

Page view(s)

49
checked on May 12, 2022

Download(s)

1
checked on May 12, 2022

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.