Impact of elevated glucose levels on cardiac function in STEMI patients: glucose delta as a prognostic biomarker.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetology & Metabolic Syndrome Pub Date : 2025-06-10 DOI:10.1186/s13098-025-01738-0

Bernardo F Garcia, Francisco A Fonseca, Maria C Izar, Gilberto Szarf, Attilio Galhardo, Ibraim M Pinto, Adriano M Caixeta, Adriano P Barbosa, Henrique T Bianco

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引用次数: 0

Abstract

Background: Elevated glucose levels have emerged as a significant prognostic factor following acute myocardial infarction (AMI).

Objective: This study aimed to evaluate glycemic parameters associated with infarct size and left ventricular function.

Research design and methods: A total of 244 patients with ST-segment elevation myocardial infarction (STEMI) treated using a pharmacoinvasive strategy were included. Glucose delta was calculated as the difference between mean glucose levels estimated from glycated hemoglobin (HbA1c) and serum glucose levels collected at hospital admission. Infarct size and left ventricular ejection fraction (LVEF) were assessed 30 days post-infarction using cardiac magnetic resonance (CMR) imaging.

Results: Higher glucose delta values were significantly associated with reduced LVEF and larger infarct size, regardless of diabetes diagnosis. Differences in infarcted ventricular mass were noted between diabetic and non-diabetic patients above specific thresholds: (18.62 ± 11.0 g) vs. (16.24 ± 13.17 g), p = 0.019, with an effect size of 0.55. The receiver operating characteristic curve yielded an area under the curve (AUC) of 0.65 (95% CI 0.57-0.72).

Conclusions: In STEMI patients undergoing pharmacoinvasive treatment, a higher glycemic delta was associated with greater infarct size and lower LVEF. This straightforward glycemic parameter provides valuable prognostic insight for both diabetic and non-diabetic populations.

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葡萄糖水平升高对STEMI患者心功能的影响：葡萄糖δ作为预后生物标志物

背景：血糖水平升高已成为急性心肌梗死（AMI）后的一个重要预后因素。目的：本研究旨在评估与梗死面积和左心室功能相关的血糖参数。研究设计和方法：244例st段抬高型心肌梗死（STEMI）患者采用药物侵入治疗。葡萄糖δ是根据糖化血红蛋白（HbA1c）估计的平均葡萄糖水平与入院时收集的血清葡萄糖水平之间的差值计算的。梗死后30天采用心脏磁共振（CMR）成像评估梗死面积和左心室射血分数（LVEF）。结果：与糖尿病诊断无关，较高的葡萄糖δ值与LVEF降低和梗死面积增大显著相关。在特定阈值以上，糖尿病患者与非糖尿病患者梗死心室质量的差异为：（18.62±11.0 g） vs(16.24±13.17 g), p = 0.019，效应量为0.55。受试者工作特征曲线下面积（AUC）为0.65 （95% CI 0.57-0.72）。结论：在接受药物侵入性治疗的STEMI患者中，较高的血糖δ值与较大的梗死面积和较低的LVEF相关。这个简单的血糖参数为糖尿病和非糖尿病人群提供了有价值的预后洞察。

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

Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-

CiteScore

6.20

自引率

0.00%

发文量

170

审稿时长

7.5 months

期刊介绍： Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.