| objective: To explore the relationship between stress hyperglycemia ratio and short-term prognosis in acute ST segment elevation myocardial infarction patients with diabetes undergoing primary PCI.Methods: A total of 301 patients with diabetes mellitus with acute ST segment elevation myocardial infarction admitted to our hospital from January 1,2017 to May 31,2018 were analyzed retrospectively.among them,there were 216 cases of stress hyperglycemia(fasting blood glucose ≥ 8.0mmol/L),8 cases of missing important data and 10 cases of loss of follow-up.All patients received direct percutaneous coronary intervention within 12 hours of onset,including 131 males(66.2%).The basic clinical data and laboratory examination indexes of the patients were collected,and the stress hyperglycemia ratio was calculated.According to the presence or absence of MACE events within 3 months of telephone or outpatient follow-up,the patients were divided into two groups: MACE event group and non-MACE event group.The clinical basic data and laboratory examination indexes of the two groups were compared.Significant variables were included in multivariate Logistic regression model analysis.Finally,independent risk factors affecting the short-term prognosis of diabetic patients with acute ST segment elevation myocardial infarction after p PCI were obtained.Results: 1.There were 50 patients in the MACE event group(25.3%).There was no significant difference in sex,smoking history,hypertension history,heart rate and systolic blood pressure at admission between the MACE group and the non-MACE group(P < 0.05).There was significant difference in age and Killip grade(P < 0.05).Comparison of laboratory indexes: SHR,NLR,fasting blood glucose,the difference between the two groups was statistically significant(P < 0.05).Comparison of angiographic results: the number of diseased vessels and Gensini score were significantly different(P < 0.05).There were 56 patients in MACE event group(21.1%).Compared with the clinical data of patients in MACE group and non-MACE group,there was no significant difference in sex and age between the two groups(P > 0.05).SHR,NLR,LDL-C,Gensini score,fasting blood glucose,Killip grade and coronary multi-branch disease were risk factors for MACE events.2.Multivariate Logisitic regression analysis showed that after adjusting for confounding factors,OR > 1,P < 0.05,age,SHR,NLR and Gensini scores were independent risk factors for MACE events.Age(OR:1.043,95%CI:1.006-1.082);Gensini-score0.023(OR:1.022,95%CI:1.009-1.035);SHR(OR:9.032,95%CI:2.274-35.881);NLR(OR:1.103,95%CI:1.006-1.211).However,FBG,Killip grade and the number of diseased blood vessels were not independent risk factors for MACE.3.The area under the ROC curve of MACE predicted by SHR and FBG was 0.704(95%CI:0.626-0.792%,P < 0.001)and 0.636(95%CI:0.525-0.707%,P < 0.002),respectively.The Yoden index of SHR was 0.371,and the corresponding cutoff value was 1.34,with a sensitivity of 52.00% and a specificity of 85.8%.4.The ROC curve comparison between SHR and FBG showed that the difference between the areas was 0.0597(95%CI: 0.0084-0.1240;P = 0.047).The predictive value of SHR for MACE events was higher than that of FBG.Conclusion: 1.In this study,the risk factors for MACE events in patients with diabetes mellitus associated with STEMI after emergency PCI were age,SHR,NLR,fasting blood glucose,Killip grade,number of disaffected vessels,and Gensini score.2.Age,SHR,NLR,and Gensini scores were independent risk factors for MACE events in patients with diabetes mellitus with STEMI after emergency PCI.3.The Youden index of SHR was 0.371 and the corresponding cut-off value was 1.34,indicating a sensitivity of 52.00% and a specificity of 85.8%.The predictive value of SHR for MACE events was higher than that of FBG. |
PDF Full Text Request