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Analyzing the non-linear relationship between fasting blood glucose levels and Gensini score in patients with STEMI

Han Li1, Quanzhi Lin2, Zhiyuan Jiang1

  • 1Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Frontiers in Cardiovascular Medicine
|January 3, 2025
PubMed

Insights

Both low and high blood sugar levels are linked to severe coronary artery disease in ST-segment elevation myocardial infarction patients. This U-shaped relationship highlights the need for careful glucose management in STEMI care.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a major global health concern.
  • Diabetes mellitus (DM) is a significant risk factor for STEMI.
  • The Gensini score quantifies coronary artery lesion severity, but its non-linear relationship with fasting blood glucose (FBG) in STEMI patients requires further investigation.

Purpose of the Study:

  • To investigate the non-linear relationship between fasting blood glucose (FBG) levels and coronary artery lesion severity, as measured by the Gensini score, in patients with ST-segment elevation myocardial infarction (STEMI).
  • To determine if both hypoglycemia and hyperglycemia are associated with increased Gensini scores in STEMI patients.

Main Methods:

  • Analysis of data from 464 STEMI patients undergoing percutaneous coronary intervention.
  • Stratification of patients into three FBG tertiles.
  • Application of statistical analyses, including LASSO regression and curve fitting, to assess the FBG-Gensini score relationship.

Main Results:

  • Significant differences in Gensini scores were observed across FBG tertiles.
  • Both hypoglycemic and hyperglycemic extremes were associated with higher Gensini scores compared to the normoglycemic range.
  • Curve fitting confirmed a significant U-shaped, non-linear association between FBG levels and coronary artery lesion severity, irrespective of diabetes status.

Conclusions:

  • Both hypoglycemia and hyperglycemia are significant risk factors for severe coronary lesions in STEMI patients, as indicated by the Gensini score.
  • Comprehensive FBG monitoring and management are crucial for improving outcomes in STEMI patients.
  • The findings emphasize the complex interplay between glycemic control and cardiovascular disease severity in STEMI.
Abstract

Keywords:
Gensini scoreST-elevation myocardial infarctionacute myocardial infarctiondiabetes mellitusfasting blood glucose

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