Association between admission-blood-glucose-to-albumin ratio and clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention

Cien Zhen; Wei Chen; Weikun Chen; Hualin Fan; Zijing Lin; Lihuan Zeng; Zehuo Lin; Weibin He; Yu Li; Shimin Peng; Lin Zeng; Chongyang Duan; Ning Tan; Yuanhui Liu; Pengcheng He

doi:10.3389/fcvm.2023.1132685

Association between admission-blood-glucose-to-albumin ratio and clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention

Front Cardiovasc Med. 2023 Sep 7:10:1132685. doi: 10.3389/fcvm.2023.1132685. eCollection 2023.

Authors

Cien Zhen^{1

2

3}, Wei Chen⁴, Weikun Chen^{2

3}, Hualin Fan^{1

2

3}, Zijing Lin^{2

3

5}, Lihuan Zeng⁶, Zehuo Lin^{2

3

7}, Weibin He^{2

3}, Yu Li^{2

3

5}, Shimin Peng^{2

3}, Lin Zeng^{2

3}, Chongyang Duan⁸, Ning Tan^{2

3}, Yuanhui Liu^{2

3

1}, Pengcheng He^{1

2

3}

Affiliations

¹ Department of Cardiology, School of Medicine, South China University of Technology, Guangzhou, China.
² Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
³ Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Cardiovascular Institute, Guangzhou, China.
⁴ Department of Cardiology, Fujian Provincial Clinical College of Fujian Medical University, Fujian Provincial Hospital, Fujian Institute of Cardiovascular Disease, Fuzhou, China.
⁵ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁶ Department of Cardiology, Guangdong Provincial People's Hospital's Nanhai Hospital, The Second Hospital of Nanhai District Foshan City, Foshan, China.
⁷ Shantou University Medical College, Shantou, China.
⁸ Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.

Abstract

Introduction: It is unclear whether admission-blood-glucose-to-albumin ratio (AAR) predicts adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who are treated with percutaneous coronary intervention (PCI). Here, we performed a observational study to explore the predictive value of AAR on clinical outcomes.

Methods: Patients diagnosed with STEMI who underwent PCI between January 2010 and February 2020 were enrolled in the study. The patients were classified into three groups according to AAR tertile. The primary outcome was in-hospital all-cause mortality, and the secondary outcomes were in-hospital major adverse cardiac events (MACEs), as well as all-cause mortality and MACEs during follow-up. Logistic regression, Kaplan-Meier analysis, and Cox proportional hazard regression were the primary analyses used to estimate outcomes.

Results: Among the 3,224 enrolled patients, there were 130 cases of in-hospital all-cause mortality (3.9%) and 181 patients (5.4%) experienced MACEs. After adjustment for covariates, multivariate analysis demonstrated that an increase in AAR was associated with an increased risk of in-hospital all-cause mortality [adjusted odds ratio (OR): 2.72, 95% CI: 1.47-5.03, P = 0.001] and MACEs (adjusted OR: 1.91, 95% CI: 1.18-3.10, P = 0.009), as well as long-term all-cause mortality [adjusted hazard ratio (HR): 1.64, 95% CI: 1.19-2.28, P = 0.003] and MACEs (adjusted HR: 1.58, 95% CI: 1.16-2.14, P = 0.003). Receiver operating characteristic (ROC) curve analysis indicated that AAR was an accurate predictor of in-hospital all-cause mortality (AUC = 0.718, 95% CI: 0.675-0.761) and MACEs (AUC = 0.672, 95% CI: 0.631-0.712).

Discussion: AAR is a novel and convenient independent predictor of all-cause mortality and MACEs, both in-hospital and long-term, for STEMI patients receiving PCI.

Keywords: ST-segment elevation myocardial infarction; admission blood glucose; albumin; percutaneous coronary intervention; predictor.

Grants and funding

This work was supported by the Shuangqing Talent Program Project of Guangdong Provincial People's Hospital (grant nos. KJ012019084 and KJ012019095), the High-level Hospital Construction Project (grant no. DFJH2020021), Guangdong Provincial People's Hospital Clinical Research Fund (Y012018085), the Fundamental Research Funds for the Central Universities (grant no. 2022ZYGXZR039), and the Project of Administration of Traditional Chinese Medicine of Guangdong Province (20221007).