Prognostic value of glycemic gap in ST-segment elevation myocardial infarction-associated acute kidney injury.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

BMC Nephrology Pub Date : 2025-05-15 DOI:10.1186/s12882-025-04167-3

Xiaofu Zhang, Yong Li, Qinghuan Yang, Siwen Wu, Yang Song, Ziyun Luo, Jianping Xu

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引用次数: 0

Abstract

Background: Stress-induced hyperglycemia (SIH) is a common phenomenon in acute myocardial infarction and is associated with poor prognosis. The relationship between glycemic gap (GG), a marker of SIH, and ST-segment elevation myocardial infarction (STEMI)-associated acute kidney injury (STAAKI) remains unclear. This study aims to explore the predictive value of GG for the risk of STAAKI after percutaneous coronary intervention (PCI) in STEMI patients.

Methods: This study retrospectively selected patients diagnosed with STEMI who underwent primary PCI. Logistic regression analysis was used to identify the risk factors associated with STAAKI. To examine the dose-response relationship between GG and STAAKI, restricted cubic splines (RCS) were employed. The predictive accuracy of the models was assessed using Delong test, net reclassification index (NRI) and integrated discrimination improvement (IDI).

Results: This study included 595 patients, the incidence of STAAKI was 9.2%. Multivariate logistic regression showed LVEF (OR per 1% increase = 0.931, 95% CI: 0.895 ~ 0.969), NT-proBNP (OR per 1 pg/mL increase = 1.579, 95% CI: 1.212 ~ 2.057), and GG (OR per 1 mmol/L increase = 1.379, 95% CI: 1.223 ~ 1.554) as independent predictors of STAAKI. RCS analysis indicated a linear dose-response relationship between GG and STAAKI. After integrating GG, the new model could significantly improve the risk model for STAAKI (Z = 2.77, NRI = 0.780, and IDI = 0.095; All P < 0.05).

Conclusion: GG is an independent risk factor for the occurrence of STAAKI after PCI in STEMI patients, and integrating GG can significantly improve risk modeling regarding STAAKI.

Clinical trial number: Not applicable.

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血糖间隙对st段抬高型心肌梗死相关性急性肾损伤的预后价值。

背景：应激性高血糖（SIH）是急性心肌梗死的常见现象，且与预后不良有关。血糖间隙（GG）是SIH的标志，与st段抬高型心肌梗死（STEMI）相关急性肾损伤（STAAKI）之间的关系尚不清楚。本研究旨在探讨GG对STEMI患者经皮冠状动脉介入治疗（PCI）后STAAKI风险的预测价值。方法：本研究回顾性选择诊断为STEMI并接受首次PCI治疗的患者。采用Logistic回归分析确定与STAAKI相关的危险因素。为了检验GG和STAAKI之间的剂量-反应关系，采用了限制性三次样条（RCS）。采用Delong检验、净重分类指数（NRI）和综合判别改进（IDI）对模型的预测精度进行评价。结果：本研究纳入595例患者，STAAKI发生率为9.2%。多因素logistic回归显示，LVEF（每增加1%的OR = 0.931, 95% CI: 0.895 ~ 0.969）、NT-proBNP（每增加1 pg/mL的OR = 1.579, 95% CI: 1.212 ~ 2.057）和GG（每增加1 mmol/L的OR = 1.379, 95% CI: 1.223 ~ 1.554）是STAAKI的独立预测因子。RCS分析显示，GG与STAAKI呈线性剂量效应关系。整合GG后，新模型能显著改善STAAKI风险模型（Z = 2.77, NRI = 0.780, IDI = 0.095）；结论：GG是STEMI患者PCI术后发生STAAKI的独立危险因素，整合GG可显著改善STAAKI的风险建模。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.30

自引率

0.00%

发文量

375

审稿时长

3-8 weeks

期刊介绍： BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.