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Association of Abnormal Glucose Metabolism and Inflammation With Prognosis in Patients With Acute Coronary Syndrome

Chong Zhang1, Wenjin Peng2,3,4,5,6, Tianqi Wang2,3,4,5,6,7

  • 1Neuroscience Intensive Care Unit, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Journal of Diabetes
|July 31, 2025
PubMed

Insights

Acute coronary syndrome patients with abnormal glucose metabolism and high inflammation face increased major adverse cardiovascular events (MACE) risk. Early treatment can mitigate this risk.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Inflammation Research

Background:

  • The interplay between glucose metabolism markers (triglyceride-glucose index, stress hyperglycemia ratio) and inflammation in acute coronary syndrome (ACS) is not well understood.
  • The long-term prognostic impact of these interactions in ACS patients requires further clinical investigation.

Purpose of the Study:

  • To investigate the relationship between glucose metabolism markers and inflammatory markers in ACS patients.
  • To identify distinct patient phenotypes based on these markers.
  • To assess the association between these phenotypes and 1-year major adverse cardiovascular events (MACE) risk.

Main Methods:

  • K-means clustering was applied to triglyceride-glucose (TyG) index, stress hyperglycemia ratio (SHR), and specific inflammatory markers (HMGB1, PDGF, PGN, LPA, citrullinated H3).
  • A Cox proportional hazards model analyzed the link between identified cluster phenotypes and 1-year MACE risk in 363 ACS patients.

Main Results:

  • A positive correlation was observed between SHR, TyG index, and inflammatory markers.
  • Two distinct phenotypes emerged: normal glucose metabolism/low inflammation and abnormal glucose metabolism/high inflammation.
  • The abnormal glucose metabolism/high inflammation phenotype significantly increased 1-year MACE risk (aHR: 3.84, 95% CI: 1.93-7.64).
  • Early guideline-directed medical therapy reduced MACE risk in the high-risk group.

Conclusions:

  • ACS patients exhibiting both abnormal glucose metabolism and heightened inflammation possess a substantially elevated risk of long-term MACE.
  • Targeted interventions, including guideline-directed medical therapy, anti-inflammatory agents, and hypoglycemic drugs, show promise for improving outcomes in this high-risk cohort.
Abstract

Keywords:
acute coronary syndromeinflammatory markersmajor adverse cardiovascular eventsstress hyperglycemia ratiotriglyceride‐glucose

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