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[Leuko-glycemic index in patients with ST elevation myocardial infarction]

Juan Carlos Reyes-Villarreal1, Joel Eduardo Morales-Gutiérrez2, Berenice López-Zamora2

  • 1Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Departamento de Medicina Interna. Ciudad de México, México.

Revista Medica Del Instituto Mexicano Del Seguro Social
|June 27, 2022
PubMed

Insights

A high leuko-glycemic index (LGI) over 1200 is a significant predictor of intrahospital non-cardiovascular complications (IHnCVCs) in ST-segment elevation myocardial infarction (STEMI) patients. This finding aids in risk stratification and management of STEMI patients.

Area of Science:

  • Cardiology
  • Biochemistry
  • Critical Care Medicine

Background:

  • Mortality in myocardial infarction (MI) extends beyond cardiovascular issues, encompassing intrahospital non-cardiovascular complications (IHnCVCs).
  • The leuko-glycemic index (LGI) has emerged as a prognostic marker for cardiovascular complications in MI.
  • Identifying predictors for IHnCVCs in ST-segment elevation myocardial infarction (STEMI) is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the optimal cut-off point of the leuko-glycemic index (LGI) for predicting intrahospital non-cardiovascular complications (IHnCVCs).
  • To investigate the association between LGI and the development of IHnCVCs in patients with ST-segment elevation myocardial infarction (STEMI).

Main Methods:

  • A single-center, cross-sectional study involving 1294 patients diagnosed with STEMI.
  • Biochemical analysis of glucose and leucocytes to calculate the LGI.
  • Receiver operating characteristic (ROC) curve analysis, univariate, bivariate, and multivariate analyses were employed to identify predictors of IHnCVCs.

Main Results:

  • The study included 1294 patients (79.8% male) with common comorbidities including hypertension, diabetes mellitus, and dyslipidemia.
  • Nearly half (49.8%) of the patients experienced IHnCVCs.
  • An LGI greater than 1200 was identified as a significant predictor (AUC 0.817) for IHnCVCs development in STEMI patients. Other significant factors included elevated creatinine, diabetes mellitus, and age over 65.
  • Hospital-acquired pneumonia and cardiovascular complications were associated with increased mortality risk in STEMI patients.

Conclusions:

  • A leuko-glycemic index (LGI) exceeding 1200 significantly increases the risk of developing intrahospital non-cardiovascular complications (IHnCVCs) in ST-segment elevation myocardial infarction (STEMI) patients by over ninefold.
  • The LGI serves as a valuable prognostic marker for identifying STEMI patients at higher risk for IHnCVCs, enabling targeted interventions.
Abstract

Keywords:
Cardiovascular DiseasesDiagnosisIntrahospital Non-cardiovascular ComplicationsMyocardial InfarctionPrognosis

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