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The Glucose-to-Lymphocyte Ratio Predicts All-cause Mortality and Cardiovascular Mortality in ST-Elevation Myocardial
Jinfang Pu1, Hongxing Zhang1, Feng Wang2
1The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China.
Insights
The glucose-to-lymphocyte ratio (GLR) can predict mortality in ST-elevation myocardial infarction (STEMI) patients undergoing emergency percutaneous coronary intervention (PCI). A high GLR indicates a significantly increased risk of both all-cause and cardiovascular mortality.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation and Metabolism
Background:
- Systemic inflammation and glucose metabolism are critical factors influencing survival in ST-elevation myocardial infarction (STEMI) patients.
- The interplay between inflammation and metabolic status is increasingly recognized as a key determinant of cardiovascular outcomes.
- Understanding novel predictive markers is crucial for risk stratification in STEMI management.
Purpose of the Study:
- To evaluate the glucose-to-lymphocyte ratio (GLR) as a potential predictor of prognosis in STEMI patients.
- To determine if GLR can stratify risk for all-cause and cardiovascular mortality following emergency percutaneous coronary intervention (PCI).
- To establish the predictive accuracy of GLR using established statistical methods.
Main Methods:
- Retrospective analysis of 1086 STEMI patients treated with emergency PCI.
- Calculation of the glucose-to-lymphocyte ratio (GLR = glucose / lymphocyte count).
- Application of Cox proportional hazard regression and Kaplan-Meier survival analyses.
- Utilized Receiver Operating Characteristic (ROC) curves to assess predictive performance for mortality outcomes.
Main Results:
- High GLR was significantly associated with increased risks of all-cause mortality (HR=2.530) and cardiovascular mortality (HR=3.859) in STEMI patients.
- The optimal GLR threshold for predicting death was determined to be 79.61.
- ROC analysis demonstrated moderate predictive value for GLR in all-cause mortality (AUC=0.678) and cardiovascular mortality (AUC=0.716).
Conclusions:
- The glucose-to-lymphocyte ratio (GLR) shows potential as a prognostic biomarker in STEMI patients receiving emergency PCI.
- A high GLR is linked to a substantially elevated risk of both all-cause and cardiovascular mortality.
- GLR may serve as a valuable, easily accessible tool for risk stratification in this patient population.
Background:
Systemic inflammation and glucose metabolism are strongly associated with survival in ST-elevation myocardial infarction (STEMI) patients. Therefore, we aimed to assess whether the glucose-to-lymphocyte ratio (GLR) could be used to predict the prognosis of STEMI patients who received emergency percutaneous coronary intervention (PCI) treatment.
Methods:
The GLR was calculated as follows: GLR = glucose (mg/dL) / lymphocyte count (K/μL). Patients were divided into two groups according to the median GLR, with the low-GLR group (GLR <81) employed as the reference group. We used Cox proportional hazard regression analyses to determine the predictive value of clinical indicators. Kaplan‒Meier curves were used to plot survival curves for both groups. The receiver operating characteristic (ROC) curves were used to assess the predictive value of the GLR for the risk of all-cause mortality and cardiovascular mortality in STEMI patients. Meanwhile, to evaluate the predictive effectiveness of the models, we plotted the ROC curves for each model.
Results:
We retrospectively analyzed 1086 newly admitted patients with STEMI who underwent emergency PCI at the First Affiliated Hospital of Kunming Medical University from June 2018 to January 2023 (mean follow-up time, M ± standard deviation (SD): 1100.66 ± 539.76 days). The results showed that high GLR was associated with increased risks of all-cause mortality (hazard ratio (HR) = 2.530, 95% CI = 1.611-3.974, p < 0.001) and cardiovascular mortality (HR = 3.859, 95% CI = 2.225-6.691, p < 0.001). The optimal GLR threshold for predicting all-cause and cardiovascular death was 79.61 (K/μL), with a ROC for all-cause death of 0.678 (95% CI: 0.625-0.732, p < 0.001), a sensitivity of 77.4%, a specificity of 51.9%, and a ROC for cardiovascular death of 0.716 (95% CI: 0.666-0.767, p < 0.001), with a sensitivity of 88.4% and a specificity of 52.1%.
Conclusions:
The GLR may potentially predict all-cause mortality and cardiovascular mortality in STEMI patients who received emergency PCI treatment. A high GLR was associated with a greater risk of all-cause mortality and cardiovascular mortality in STEMI patients.
