狼牙棒
医学
内科学
危险系数
心肌梗塞
心脏病学
心房颤动
比例危险模型
逻辑回归
置信区间
心力衰竭
回顾性队列研究
冲程(发动机)
经皮冠状动脉介入治疗
机械工程
工程类
作者
Jiachen Luo,Zhiqiang Li,Xiaoming Qin,Xingxu Zhang,Xiangdong Liu,Wenming Zhang,Wei Xu,Baoxin Liu,Yidong Wei
摘要
Abstract Aims To investigate the predictive value and prognostic impact of stress hyperglycemia ratio (SHR) for new‐onset atrial fibrillation (NOAF) complicating acute myocardial infarction (AMI). Materials and Methods This retrospective study included 2145 AMI patients without AF history between February 2014 and March 2018. SHR was calculated using fasting blood glucose (mmol/L)/[1.59*HbA1c (%)‐2.59]. The association between SHR and post‐MI NOAF was assessed with multivariable logistic regression analyses. The primary outcome was a composite of cardiac death, heart failure hospitalisation, recurrent MI, and ischaemic stroke (MACE). Cox regression‐adjusted hazard ratios with 95% confidence intervals (CI) were estimated for MACE. Results A total of 245 (11.4%) patients developed NOAF. In the multivariable logistic regression analyses, SHR (each 10% increase) was significantly associated with increased risks of NOAF in the whole population (OR: 1.05, 95% CI: 1.01–1.10), particularly in non‐diabetic individuals (OR:1.08, 95% CI: 1.01–1.17). During a median follow‐up of 2.7 years, 370 (18.5%) MACEs were recorded. The optimal cut‐off value of SHR for MACE prediction was 1.119. Patients with both high SHR (≥1.119) and NOAF possessed the highest risk of MACE compared to those with neither high SHR nor NOAF after multivariable adjustment (HR: 2.18, 95% CI: 1.39–3.42), especially for diabetics (HR: 2.63, 95% CI: 1.41–4.91). Similar findings were observed using competing‐risk models. Conclusions SHR is an independent predictor of post‐MI NOAF in non‐diabetic individuals. Diabetic patients with both high SHR and NOAF had the highest risk of MACE, suggesting that therapies targeting SHR may be considered in these patients. Trial registration ClinicalTrials.gov , NCT03533543.
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