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Published on: May 28, 2019
[Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial
Ebrey León-Aliz1, Francisco L Moreno-Martínez2, Guillermo A Pérez-Fernández1
1Servicio de Cardiología, Hospital Dr. Celestino Hernández Robau, Villa Clara, Cuba.
Insights
The leuko-glycemic index, calculated from blood glucose and white blood cell counts, is a significant predictor of poor outcomes in ST-segment elevation myocardial infarction patients. Higher index values indicate a greater risk of death and complications.
Area of Science:
- Cardiology
- Clinical Biochemistry
Context:
- Prognostic significance of admission blood glucose and white blood cell count in myocardial infarction (MI) is established.
- The leuko-glycemic index (LGI) is a novel marker requiring further investigation for its prognostic value.
Purpose:
- To assess the prognostic capability of the leuko-glycemic index in patients diagnosed with ST-segment elevation myocardial infarction (STEMI).
Summary:
- A retrospective analysis of 128 STEMI patients revealed that higher admission leuko-glycemic index values correlated with adverse outcomes, including death, major cardiac complications, and failed thrombolysis.
- A cutoff LGI of 1.158 indicated a threefold increased probability of death and complications.
- Multivariate analysis confirmed LGI as an independent predictor of in-hospital mortality and complications.
Impact:
- The leuko-glycemic index serves as a valuable, independent predictor of in-hospital mortality and complications in STEMI patients.
- This finding supports the integration of LGI assessment into routine clinical practice for risk stratification in STEMI management.
Introduction:
Blood glucose and white blood cell count on admission have demonstrated prognostic significance in patients with myocardial infarction; leuko-glycemic index, a recently proposed marker, still lacks enough knowledge about its value.
Objectives:
To evaluate the leuko-glycemic index as a prognostic marker in patients with ST-segment elevation myocardial infarction.
Methods:
A retrospective study was carried out in 128 patients with ST-segment elevation myocardial infarction, who were admitted between January 2009 and October 2010 in the Intensive Care Unit of the Hospital Dr. Celestino Hernández Robau. Clinical and laboratory data were collected, including glucose and white blood cell count on admission, from which we calculated the leuko-glycemic index and we evaluated its prognostic value.
Results:
Patients who had a poor outcome such as death, major cardiac complications and failed-thrombolysis, showed higher values of leuko-glycemic index (P<.01), which was correlated with several variables such as Killip class, and heart rate on admission (P=.000). We obtained a cutoff point of 1.158, patients with higher values had 3 times higher probability of death and complications (odds ratio=3,0; IC 95%: 1,2-7,3; P=.005); so leuko-glycemic index was an independent predictor after multivariate analysis.
Conclusions:
The leuko-glycemic index was associated with an increased occurrence of hospital complications, death and failed-thrombolysis; its pathological value was an independent predictor of in-hospital death and complications in the studied sample.
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