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. 2024 Oct 26:23:200347.
doi: 10.1016/j.ijcrp.2024.200347. eCollection 2024 Dec.

Predictive value of glucose coefficient of variation for in-hospital mortality in acute myocardial infarction patients undergoing PCI: Insights from the MIMIC-IV database

Zixuan Zhang  1   2 , Mengmeng Ji  1   2 , Qingqing Zhao  1 , Luying Jiang  1   2 , Shilang Fan  2   3 , Houjuan Zuo  1   2
Affiliations

Predictive value of glucose coefficient of variation for in-hospital mortality in acute myocardial infarction patients undergoing PCI: Insights from the MIMIC-IV database

Zixuan Zhang et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: Acute myocardial infarction (AMI) carries a high short-term risk of death, even after percutaneous coronary intervention (PCI). Glucose variability (GV), measured by the glucose coefficient of variation (GluCV), is a potential risk factor for adverse outcomes. This study investigates GluCV's predictive value for in-hospital mortality in AMI patients undergoing PCI.

Method: This study involved 2325 AMI patients who were admitted to the ICU and underwent PCI from the MIMIC-IV database. Patients were categorized into quartiles based on GluCV: <0.13, 0.13-0.20, 0.20-0.29, and ≥0.29. Multivariable logistic regression and Restricted cubic spline (RCS) analysis were employed to analyze the relationship between GluCV and in-hospital mortality. Mediation analysis was used to evaluate the role of GluCV in the relationship between disease complexity and severity.

Results: Among the 2325 patients, 203 (8.7 %) died during hospitalization. Higher GluCV was associated with increased in-hospital mortality. Adjusted odds ratios for mortality were 1.35 (95 % CI: 0.71-2.55), 1.91 (95 % CI: 1.04-3.51), and 3.32 (95 % CI: 1.83-6.02) for the second, third, and fourth groups, respectively. RCS analysis indicated a linear relationship between Log GluCV and mortality risk, with each 1 SD increase in Log GluCV associated with a 1.70-fold increase in mortality. Subgroup analysis showed a stronger relationship between GluCV and mortality in patients younger than 70. Mediation analysis indicated that GluCV partially mediates the effect of comorbidities on organ dysfunction.

Conclusions: GluCV is an important predictor of in-hospital mortality in AMI patients undergoing PCI. Managing GV to minimize fluctuations may improve patient prognosis.

Keywords: Acute myocardial infarction; Glucose coefficient of variation; Glucose variability; In-hospital mortality; Percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow chart of the inclusion of the study population.
Fig. 2
Fig. 2
The association between GluCV and in-hospital death. OR = Odds Ratio, CI = Confidence Interval, Ref = Reference.
Fig. 3
Fig. 3
Restricted cubic spline plots for the association of GluCV with in-hospital death. (A) unadjusted model; (B) adjusted model. Log GluCV = log glucose coefficient of variation; OR = Odds Ratio; SD = standard deviation.
See this image and copyright information in PMC

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