Risk analysis of the association between different hemoglobin glycation index and poor prognosis in critical patients
Xing Wei1,2, Xinghua Chen2,3, Zhipeng Zhang1,2
1Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
Insights
The hemoglobin glycation index (HGI) can predict mortality in critical coronary artery disease patients. Low HGI is linked to increased 30-day and 365-day mortality, while high HGI also associates with 365-day mortality.
Area of Science:
- Cardiology
- Metabolic Medicine
- Clinical Research
Background:
- The hemoglobin glycation index (HGI) quantifies discrepancies between observed and predicted glycosylated hemoglobin (HbA1c).
- HGI is linked to adverse prognoses, but its role in critical coronary artery disease (CAD) remains unexplored.
- This study investigates the association between HGI and all-cause mortality in critical CAD patients.
Purpose of the Study:
- To analyze the correlation between HGI and all-cause mortality in critical coronary artery disease.
- To evaluate HGI as a prognostic marker in this patient population.
Main Methods:
- HGI was calculated using linear regression between HbA1c and fasting plasma glucose (FPG).
- Kaplan-Meier survival analysis and log-rank tests assessed mortality differences across HGI quartiles.
- Cox proportional hazards models and restricted cubic splines (RCS) evaluated HGI's risk for mortality.
Main Results:
- A total of 5260 critical CAD patients were analyzed, with 30-day and 365-day mortality rates of 4.94% and 13.12%, respectively.
- Low HGI significantly correlated with increased 30-day (HR 1.96) and 365-day (HR 1.48) mortality.
- High HGI also showed an association with 365-day mortality (HR 1.31), and RCS revealed a U-shaped relationship.
Conclusions:
- HGI is significantly correlated with all-cause mortality in critical coronary artery disease patients.
- Low HGI emerges as a particularly strong predictor of short- and long-term mortality.
- HGI serves as a potential indicator for assessing mortality risk in critical CAD.
Background:
The hemoglobin glycation index (HGI) is the difference between the observed and predicted values of glycosylated hemoglobin (HbA1c), which is closely associated with a variety of poor prognoses. However, there are still no studies on the correlation between HGI and poor prognosis in patients with critical coronary artery disease. The purpose of this study was to analyze the correlation between HGI and all-cause mortality in patients with critical coronary artery disease using the MIMIC-IV database.
Methods:
The HGI was calculated by constructing a linear regression equation between HbA1c and fasting plasma glucose (FPG). A Kaplan‒Meier survival analysis model was constructed based on the HGI quartiles to clarify the differences in all-cause mortality rates between groups, and the log-rank test was used to assess the differences between groups. The hazard ratio (HR) of HGI as a risk factor for outcome events was assessed using the Cox proportional risk model and restricted cubic spline (RCS), with the Q2 group serving as the reference group.
Results:
A total of 5260 patients were included in this study. The 30-day mortality rate of the patients was 4.94% and the mortality rate within 365 days was 13.12%. A low HGI was significantly associated with 30-day mortality (HR, 1.96; 95% CI, (1.38, 2.78); P < 0.001) and 365-day mortality (HR, 1.48; 95% CI, (1.19, 1.85); P < 0.001) in patients with critical coronary artery disease in the completely adjusted Cox proportional risk model. In addition, high levels of HGI were associated with 365-day mortality (HR, 1.31; 95% CI, (1.02, 1.69); P < 0.05). RCS analysis revealed a U-shaped relationship between HGI and outcome events. According to the stratified analysis, the interaction test revealed that the correlation between HGI and outcome events remained stable.
Conclusion:
There was a significant correlation between HGI and all-cause mortality in patients with critical coronary artery disease, particularly in those with low HGI. HGI can be used as a potential indicator for assessing the short- and long-term risk of mortality in such patients.
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