Abstract
BackgroundIt has been demonstrated that glycated albumin (GA) is significantly associated with diabetes complications and mortality. However, among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear.MethodsThis study eventually included 2247 NSTE-ACS patients in Beijing Anzhen Hospital, Capital Medical University in January-December 2015 who received PCI. All patients were followed up until death or for 48 months post-discharge. The primary endpoint was major adverse cardio-cerebral events (MACCEs), including all-cause death, non-fatal myocardial infarction, ischemia-induced revascularization and non-fatal ischemic stroke.ResultsIn total, 547 (24.3%) MACCEs were recorded during the follow-up period. Upon adjusting for potential confounders, GA remained an important risk predictor of MACCEs (As nominal variate: hazard ratio [HR] 1.527, 95% confidence interval [CI] 1.236–1.886, P < 0.001; As continuous variate: HR 1.053, 95% CI 1.027–1.079, P < 0.001). GA addition significantly enhanced the predictive ability of the traditional risk model (Harrell’s C-index, GA vs. Baseline model, 0.694 vs. 0.684, comparison P = 0.002; continuous net reclassification improvement (continuous-NRI) 0.085, P = 0.053; integrated discrimination improvement (IDI) 0.007, P = 0.020).ConclusionGA is highly correlated with poor prognosis in NSTE-ACS patients undergoing PCI, suggesting that it may be a major predictive factor of adverse events among these individuals.
Highlights
Type 2 diabetes mellitus (T2DM) independently and significantly predicts atherosclerotic cardiovascular disease (ASCVD), and increases ASCVD risk by about 2Liu et al Cardiovascular Diabetology (2022) 21:11 mortality [6]
The present work firstly assessed the predictive value of glycated albumin (GA) for poor prognosis in NSTE-acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI)
We found that the incidence of Major adverse cardio-cerebral event (MACCE) was markedly elevated in individuals with high GA levels in comparison with the low GA group
Summary
Type 2 diabetes mellitus (T2DM) independently and significantly predicts atherosclerotic cardiovascular disease (ASCVD), and increases ASCVD risk by about 2Liu et al Cardiovascular Diabetology (2022) 21:11 mortality [6]. Elevated FBG levels significantly increase 6-month mortality in patients with ACS [7]. In cases for whom FBG and HbA1c have the above limitations and cannot accurately reflect the patient’s blood glucose levels, GA would be a good surrogate indicator [9]. GA has been confirmed to be closely related to CAD, ischemic stroke, heart failure, cardiovascular death and other diseases [16]. It was shown serum GA represents a better marker compared with HbA1c for evaluating the presence of CAD, assessing CAD severity and predicting major adverse cardiovascular events [17]. Among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTEACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear
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