亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Impact of glycemic gap on 30-day adverse outcomes in patients with acute ST-segment elevation myocardial infarction

医学 内科学 血糖性 心肌梗塞 仰角(弹道) 心脏病学 ST段 不利影响 胰岛素 几何学 数学
作者
Shuang Wu,Yanmin Yang,Jun Zhu,Wei Xu,Lu‐Lu Wang,Si‐qi Lyu,Juan Wang,Xing‐hui Shao,Han Zhang
出处
期刊:Atherosclerosis [Elsevier BV]
卷期号:360: 34-41 被引量:4
标识
DOI:10.1016/j.atherosclerosis.2022.10.003
摘要

Stress-induced hyperglycemia (SIH) generally occurs in critical illness. Recently, glycemic gap (GAP) has been considered to be a superior indicator of SIH. However, data on the association between GAP and prognosis in ST-segment elevation myocardial infarction (STEMI) is limited. This observational study aimed to estimate the prognostic value of GAPmean, defined as the difference between mean blood glucose level (MGL) within 24 h after admission and A1c-derived average glucose (ADAG), in patients with acute STEMI.A total of 4952 patients with acute STEMI were included in the final analysis, and they were divided into four groups according to GAPmean quartiles and diabetes mellitus (DM). The primary outcomes were all-cause mortality and major adverse cardiovascular events (MACEs). Cox proportional hazards regression analysis and net reclassification improvement (NRI) analysis were performed.At 30 days of follow-up, 324 (6.5%) deaths and 569 (11.5%) MACEs occurred. With the elevation of GAPmean, the incidence of all-cause mortality (4.0%, 5.6%, 6.5%, and 10.1%) and MACEs (7.3%, 9.6%, 11.4%, and 17.7%) significantly increased. Receiver operating characteristic curve analysis demonstrated that GAPmean was superior to admission blood glucose (ABG) and GAPadm (defined as the difference between ABG and ADAG) to detect adverse outcomes. Multivariate Cox regression analysis revealed that elevated GAPmean was independently associated with all-cause death and MACEs. With the first quartile as a reference, the hazards ratios (HRs) for all-cause death in the second, third, and fourth quartiles were 1.49 (95% CI 1.02-2.18), 1.58 (95% CI 1.09-2.30), and 2.11 (95% CI 1.48-3.02), respectively, and the HRs for MACEs were 1.40 (95% CI 1.05-1.86), 1.60 (95% CI 1.21-2.11), and 2.17 (95% CI 1.66-2.83), respectively, which were independent of DM status. Continuous NRI analysis revealed that GAPmean significantly improved risk stratification for all-cause mortality and MACEs by 21.6% and 19.8%, respectively.The glycemic gap between MGL within 24 h after admission and ADAG was independently associated with 30-day all-cause mortality and MACEs in patients with acute STEMI, which was not affected by DM status. Further, the glycemic gap provided incremental accuracy in the risk stratification of STEMI.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
12秒前
正直的松鼠完成签到 ,获得积分10
31秒前
核桃发布了新的文献求助10
1分钟前
Xw关闭了Xw文献求助
1分钟前
1分钟前
Xw关闭了Xw文献求助
1分钟前
2分钟前
Swear完成签到 ,获得积分10
2分钟前
勤恳冰淇淋完成签到 ,获得积分10
2分钟前
2分钟前
El发布了新的文献求助10
2分钟前
2分钟前
李健应助El采纳,获得10
2分钟前
义气雁完成签到 ,获得积分10
3分钟前
3分钟前
xiongdi521发布了新的文献求助10
3分钟前
美罗培南完成签到 ,获得积分10
3分钟前
lige完成签到 ,获得积分10
3分钟前
3分钟前
3分钟前
二十四桥完成签到 ,获得积分10
3分钟前
直觉应助背后的鞋垫采纳,获得10
3分钟前
桦奕兮完成签到 ,获得积分10
3分钟前
Akim应助Borhan采纳,获得10
4分钟前
4分钟前
jjjjj发布了新的文献求助10
4分钟前
Liiiiiiiiii发布了新的文献求助10
4分钟前
Eva完成签到 ,获得积分10
4分钟前
上官若男应助Liiiiiiiiii采纳,获得10
4分钟前
Liufgui应助jjjjj采纳,获得10
4分钟前
4分钟前
酷波er应助科研通管家采纳,获得10
4分钟前
科研通AI2S应助科研通管家采纳,获得10
4分钟前
核桃发布了新的文献求助30
5分钟前
田様应助最最最采纳,获得10
5分钟前
5分钟前
5分钟前
不懂白完成签到 ,获得积分10
6分钟前
6分钟前
Borhan发布了新的文献求助10
6分钟前
高分求助中
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3990075
求助须知:如何正确求助?哪些是违规求助? 3532108
关于积分的说明 11256369
捐赠科研通 3271016
什么是DOI,文献DOI怎么找? 1805171
邀请新用户注册赠送积分活动 882270
科研通“疑难数据库(出版商)”最低求助积分说明 809228