| Objective:Research Acute Myocardial Infarction(Acute Myocardial Infarction,AMI)non-diabetic patients with Stress hyperglycemia and ratio(Stress hyperglycemia thewire,SHR)level changes on the hospital outside the cardiovascular Adverse events(Major Adverse Cardiac and Cerebrovascular events,MACCE),evaluation value for the forecast of MACCE occurred after AMI.Methods:1.This retrospective study collected data from the Department of Cardiology,the Second Clinical College of Shanxi Medical University from July 2020 to January 2022.coronary coronary intervention(PCI)Coronary Coronary intervention(PCI)Coronary Coronary intervention(PCI)Coronary Coronary intervention(PCI)Coronary Coronary intervention(PCI)All patients were followed up(6-24 months,mean 12.51 months)and their clinical outcomes were known through outpatient and telephone visits.General data and biochemical indexes of patients were recorded.MACCE events recorded during follow-up included heart failure,all-cause death,recurrent angina,target vessel reconstruction,non-fatal myocardial infarction,and non-fatal stroke re-hospitalizations.MACCE was identified during follow-up based on in-hospital records provided by the patient or his or her family.SHR was calculated according to SHR formula SHR= blood glucose /[(1.59× glycosylated hemoglobin)-2.59],and the study population was further divided into low SHR group and high SHR group according to the median level of SHR.The endpoint of this study was the occurrence of MACCE in non-diabetic patients with AMI after PCI at an out-of-hospital follow-up of 6-24 months,with an average of 12.51 months.2.According to the occurrence of major cardiovascular and cerebrovascular adverse events after discharge,the patients were divided into two groups,MACCE group and non-MACCE group,to explore whether SHR was an independent risk factor for out-of-hospital MACCE events,and to compare the clinical data and biochemical indexes and SHR index of AMI non-diabetic patients after PCI between the MACCE group and non-macce group.COX regression was used to analyze the correlation between SHR and MACCE events,and two groups were divided according to the median of SHR index.Differences in basic data and MACCE incidence between the two groups were compared.KM(Kaplan-Meier)curve was used to analyze the MACCE incidence of different SHR groups.Receiver operating characteristic(ROC)curve was analyzed to evaluate the predictive value of SHR and fasting blood glucose for out-of-hospital MACCE events in AMI non-diabetic patients,and the cut-off value was calculated.In all tests,a=0.05(bilateral)was used as the standard and P<0.05(bilateral)was statistically significant.Results:The mean follow-up time was 12.51 months.A total of 58 patients reached the clinical endpoint after discharge(19.5%),including 4(1.3%)all-cause death,6(2%)target vessel reconstruction,5(1.7%)non-fatal myocardial infarction,4(1.3%)non-fatal stroke,and 10(3.3%)heart failure.Twenty-nine patients(9.7%)were hospitalized for recurrent angina pectoris.1.The relationship between SHR and MACCEComparison of clinical data between the MACCE group and the non-macce group:The comparison between the two groups showed that the age and smoking history of patients in the MACCE group were higher than those in the non-macce group(P < 0.05);in terms of biochemical indicators,the SHR,TC,TG and LDL in the MACCE group were significantly higher(P < 0.05),and the difference was statistically significant.COX regression analysis with the occurrence of MACCE events as the outcome variable showed that SHR was a risk factor for MACCE events in non-diabetic patients.Secondly,age,TC,TG,LDL-C,FBG and hypersensitive troponin were also risk factors for MACCE events.After adjusting for age,sex,hypertension,TC,TG,LDL-C and hypersensitive troponin,SHR remained an independent predictor of MACCE events(P=0.027).General data of low SHR index group(≤0.79)and high SHR index group(> 0.79)showed that compared with low SHR index group,high SHR index group was older,followed by high SHR group had higher levels of FBG and hypersensitive troponin and lower levels of glycohemoglobin.Kaplan-Meier survival curve showed that the higher the SHR index,the higher the incidence of MACCE(P = 0.01).2.Predictive value of FBG and SHR for major adverse event in non-diabetic patients with AMIThe general profile of the low and high SHR index sets compared to the low SHR index ROC curve assessed the performance of SHR in predicting MACCE.AUC(95% CI)for SHR was 0.744(0.670-0.815),respectively.Its cut-off value is 1.073,sensitivity:39.7%,specificity: 97.5.In addition,the AUC of SHR index was significantly higher than that of blood glucose,and the best cut-off value was 1.073Conclusion:SHR is an independent risk factor for out-of-hospital MACCE in AMI non-diabetic patients with PCI,and has a certain prognostic value.The higher the SHR index was,the higher the incidence of MACCE was.The diagnostic efficacy of FBG and SHR index for post-discharge MACCE in non-diabetic patients with AMI was 57.2% and 74.4%,respectively.The predictive value of SHR for out-of-hospital MACCE occurrence in non-diabetic patients with AMI was better than FBG within 24 hours after admission.The cut-off value of SHR in non-diabetic patients was 1.073.It can be a new prognostic index for AMI patients without diabetes. |
PDF Full Text Request