Use of blood glucose level for predicting the degree of coronary artery disease and cardiovascular adverse events in diabetic patients with acute coronary syndrome.

Objective: To investigate the predictive value of blood glucose level in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome (ACS) concerning the degree of coronary artery disease and major adverse cardiovascular events (MACE).

Method: A retrospective study was conducted on 104 T2DM patients with ACS who visited West China Hospital, Sichuan University, from August 2020 to March 2024. Based on the Gensini score, patients were categorized into mild (0-30 points), moderate (31-59 points), and severe (≥60 points) groups. Additionally, patients were divided into MACE and non-MACE groups based on the occurrence of MACE. General information, blood glucose levels, and coronary angiography results were collected, along with six-month follow-up data. The predictive value of blood glucose levels for the severity of coronary artery disease and cardiovascular adverse events was analyzed using receiver operating characteristic (ROC) curves.

Results: There were significant differences in the levels of glycosylated serum protein (GSP), insulin-like growth factor-1 (IGF-1), and the triglyceride-glucose (TyG) index among patients with varying degrees of coronary artery disease (P<0.05), with levels increasing in line with disease severity. The MACE group exhibited generally higher levels of GSP, IGF-1, and TyG compared to the non-MACE group (P<0.05). ROC curve analysis revealed that the area under the curve (AUC) for GSP, IGF-1, and TyG for predicting severe coronary artery disease were 0.861, 0.936, and 0.896, respectively, and for predicting MACE occurrence were 0.738, 0.814, and 0.710, respectively (P<0.05).

Conclusion: Blood glucose levels in T2DM patients with ACS have predictive value for both the severity of coronary artery disease and the occurrence of MACE. Measurement of GSP, IGF-1, and TyG is clinically significant for assessing prognosis and developing treatment strategies.