Stress hyperglycemia and early mortality in non-ST elevation myocardial infarction

Table 1 Baseline demographic and clinical characteristics stratified by glycated hemoglobin categories, n (%)/median (interquartile range)

Variable	Total (n = 171)	Normoglycemia (n = 56)	Prediabetes (n = 57)	Diabetes (n = 58)	P value
Age (years)	67 (59-75)	66 (58-74)	67 (60-76)	68 (61-77)	0.497
Male sex	118 (69.0)	40 (71.4)	39 (68.4)	39 (67.2)	0.88
Body mass index	27.5 (25.1-30.3)	27.3 (25.0-30.1)	27.6 (25.2-30.4)	27.7 (25.3-30.6)	0.971
Arterial hypertension	132 (77.2)	41 (73.2)	43 (75.4)	48 (82.8)	0.34
Admission glucose (mmol/L)	7.6 (6.4-9.1)	6.7 (6.1-7.5)	7.4 (6.5-8.4)	9.3 (8.1-11.1)	< 0.001
HbA1c (%)	6.2 (5.7-7.1)	5.5 (5.3-5.7)	6.0 (5.8-6.2)	7.7 (7.1-8.5)	< 0.001
MACE at 3 months	88 (51.5)	27 (48.2)	30 (52.6)	31 (53.4)	0.674
All-cause mortality at 3 months	25 (14.6)	7 (12.5)	8 (14.0)	10 (17.2)	0.168

HbA1c: Glycated hemoglobin A1c; MACE: Major adverse cardiovascular events.

Table 2 Admission biomarkers according to 3-month survival status, median, (interquartile range)

Variable	Survivors (n = 146)	Non-survivors (n = 25)	P value
Age, years	66 (58-73)	75 (69-82)	< 0.001
Admission glucose, (mmol/L)	7.20 (6.30-8.50)	9.10 (8.10-11.40)	0.012
HbA1c (%)	6.1 (5.7-7.0)	6.2 (5.8-7.2)	0.528
Stress hyperglycemia ratio	0.90 (0.78-1.05)	1.18 (1.02-1.35)	0.018
Admission glucose-to-chronic glycemia ratio	0.76 (0.68-0.88)	0.99 (0.87-1.12)	0.016
C-reactive protein (mg/L)	9.0 (4.0-18.0)	30.4 (18.0-62.0)	< 0.001
Pan-immune-inflammation value	561 (320-980)	1399 (850-2100)	0.005
Triglyceride-glucose index	8.8 (8.4-9.2)	9.0 (8.6-9.4)	0.18
Atherogenic index of plasma	0.26 (0.14-0.39)	0.29 (0.17-0.41)	0.31
De Ritis ratio (AST/ALT)	1.12 (0.94-1.34)	1.18 (0.97-1.42)	0.27

HbA1c: Glycated hemoglobin A1c; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase.

Table 3 Multivariable logistic regression analysis for 3-month all-cause mortality

Variable	Model 1 OR (95%CI)	P value	Model 2 OR (95%CI)	P value	Model 3 OR (95%CI)	P value
Age (per year)	1.07 (1.03-1.11)	< 0.001	1.06 (1.02-1.10)	0.002	1.05 (1.01-1.09)	0.009
Male sex	1.18 (0.51-2.71)	0.69	1.10 (0.47-2.58)	0.82	1.05 (0.44-2.51)	0.91
Serum creatinine (per 10 μmol/L)	1.09 (1.02-1.16)	0.010	1.07 (1.01-1.15)	0.028	1.05 (0.99-1.12)	0.10
Arterial hypertension	1.32 (0.54-3.20)	0.54	1.28 (0.51-3.18)	0.60	1.19 (0.47-3.01)	0.71
Admission glucose (mmol/L)	1.15 (1.03-1.29)	0.014	1.18 (1.05-1.33)	0.006	1.10 (0.97-1.25)	0.13
Stress hyperglycemia ratio	1.92 (1.14-3.24)	0.015	2.04 (1.18-3.53)	0.011	1.41 (0.78-2.56)	0.25
Left ventricular ejection fraction (per 5%)					0.72 (0.61-0.85)	< 0.001

Model 1 included age, sex, serum creatinine, arterial hypertension, admission glucose, and stress hyperglycemia ratio. Model 2 additionally included inflammatory markers (C-reactive protein and pan-immune-inflammation value). Model 3 further incorporated echocardiographic parameters, including left ventricular ejection fraction. Odds ratio are presented per unit increase unless otherwise specified. OR: Odds ratio.

Table 4 Multivariable logistic regression analysis for 3-month major adverse cardiovascular events

Variable	Model 1 OR (95%CI)	P value	Model 2 OR (95%CI)	P value	Model 3 OR (95%CI)	P value
Age (per year)	1.03 (1.01-1.05)	0.012	1.03 (1.01-1.05)	0.018	1.02 (1.00-1.05)	0.06
Male sex	1.22 (0.72-2.05)	0.46	1.19 (0.70-2.02)	0.52	1.15 (0.67-1.97)	0.61
Serum creatinine (per 10 μmol/L)	1.05 (1.01-1.09)	0.014	1.04 (1.00-1.09)	0.041	1.03 (0.99-1.08)	0.11
Arterial hypertension	1.18 (0.68-2.06)	0.56	1.15 (0.66-2.01)	0.62	1.10 (0.62-1.97)	0.74
Admission glucose (mmol/L)	1.07 (0.98-1.17)	0.12	1.07 (0.98-1.17)	0.12	1.03 (0.94-1.13)	0.53
Stress hyperglycemia ratio	1.29 (0.89-1.87)	0.18	1.29 (0.89-1.87)	0.18	1.12 (0.75-1.68)	0.57
Left ventricular ejection fraction (per 5%)					0.81 (0.73-0.90)	< 0.001

Model 1 included age, sex, serum creatinine, arterial hypertension, admission glucose, and stress hyperglycemia ratio. Model 2 additionally included inflammatory markers (C-reactive protein and pan-immune-inflammation value). Model 3 further incorporated echocardiographic parameters, including left ventricular ejection fraction. Odds ratio are presented per unit increase unless otherwise specified. OR: Odds ratio.