Association between different hemoglobin glycation index and prognosis in patients with a first diagnosis of acute myocardial infarction: a retrospective study based on the MIMIC-IV database.

Abstract

Background: The hemoglobin glycation index (HGI) is defined as the difference between the observed and predicted values of glycosylated hemoglobin (HbA1c), which is closely associated with a variety of poor prognoses. However, the relationship between HGI and short-term mortality risk in patients with a first diagnosis of acute myocardial infarction (AMI) remains unclear. This study aims to provide a better understanding of the relationship between HGI and mortality risk in patients with a first diagnosis of AMI.

Methods: We conducted a cohort study using data from 1,961 patients with a first diagnosis of AMI from the Medical Information Mart for Intensive Care IV (MIMIC-IV; version 2.2) database. Patients were divided into four groups based on HGI quartiles. A Cox proportional hazards model and a two-segmented Cox proportional hazards model were used to elucidate the non-linear relationship between HGI in patients with a first diagnosis of AMI and mortality.

Results: Of the surveyed population, 175 patients (8.92%) died within 90 days, and 210 patients (10.71%) died within 180 days. A low HGI was significantly associated with 90-day mortality [HR, 1.99; 95% CI (1.22, 3.08); P < 0.001] and 180-day mortality [HR, 1.74; 95% CI (1.18, 2.43); P < 0.001] in patients with a first diagnosis of AMI in the completely adjusted Cox proportional risk model, showing a non-linear correlation with an inflection point at 0.16 and 0.44. In the subgroup analysis, patients with prediabetes mellitus (pre-DM) and lower HGI levels had increased 90-day [HR, 8.30; 95% CI (2.91, 23.68)] and 180-day mortality risks [HR, 6.84; 95% CI (2.86, 16.34)].

Conclusion: There is a significant correlation between HGI and all-cause mortality in patients diagnosed with AMI, especially those with lower HGI. HGI can serve as a potential indicator for evaluating the 90 and 180-day death risk of such patients.