The glycemic gap as a prognostic indicator in cardiogenic shock: a retrospective cohort study

doi:10.1186/s12872-024-04138-w

科研成果详情

题名	The glycemic gap as a prognostic indicator in cardiogenic shock: a retrospective cohort study
作者	Xu, Qianqian1,2; Wang, Jinsheng1,2; Lin, Zhihui1,2; Song, Dongyan1,2; Ji, Kangting1,2; Xiang, Huaqiang 1,2
发表日期	2024-09-02
发表期刊	BMC Cardiovascular Disorders 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Glycemic gap Cardiogenic shock Prognosis Propensity score-matched analysis Inverse probability treatment weighting
其他关键词	ELEVATION MYOCARDIAL-INFARCTION ; STRESS HYPERGLYCEMIA ; GLUCOSE-METABOLISM ; INSULIN ; GLUCONEOGENESIS ; ASSOCIATION ; MORTALITY ; LACTATE ; BLOOD ; COMA
摘要	Background Stress-induced hyperglycemia (SIH) is associated with poor outcomes in cardiogenic shock (CS), and there have been inconsistent results among patients with or without diabetes mellitus (DM). The glycemic gap (GG) is derived by subtracting A1c-derived average glucose from blood glucose levels; it is a superior indicator of SIH. We aimed to explore the role of GG in the outcomes of patients with CS. Methods Data on patients diagnosed with CS were extracted from the MIMIC-IV v2.0 database to investigate the relationship between GG and 30-day mortality (Number of absolute GG subjects = 359; Number of relative GG subjects = 357). CS patients from the Second Affiliated Hospital of Wenzhou Medical University were enrolled to explore the correlation between GG and lactic acid (Number of absolute GG subjects = 252; Number of relative GG subjects = 251). Multivariate analysis, propensity score-matched (PSM) analysis, inverse probability treatment weighting (IPTW), and Pearson correlation analysis were applied. Results Absolute GG was associated with 30-day all-cause mortality in CS patients (HRadjusted: 1.779 95% CI: 1.137-2.783; HRPSM: 1.954 95% CI: 1.186-3.220; HRIPTW: 1.634 95% CI: 1.213-2.202). The higher the absolute GG level, the higher the lactic acid level (beta adjusted: 1.448 95% CI: 0.474-2.423). A similar trend existed in relative GG (HRadjusted: 1.562 95% CI: 1.003-2.432; HRPSM: 1.790 95% CI: 1.127-2.845; HRIPTW: 1.740 95% CI: 1.287-2.352; beta(adjusted):1.294 95% CI: 0.369-2.219). Subgroup analysis showed that the relationship existed irrespective of DM. The area under the curve of GG combined with the Glasgow Coma Scale (GCS) for 30-day all-cause mortality was higher than that of GCS (absolute GG: 0.689 vs. 0.637; relative GG: 0.688 vs. 0.633). GG was positively related to the triglyceride-glucose index. Kaplan-Meier curves revealed that groups of higher GG with DM had the worst outcomes. The outcomes differed among races and GG levels (all P < 0.05). Conclusions Among patients with CS, absolute and relative GGs were associated with increased 30-day all-cause mortality, regardless of DM. The relationship was stable after multivariate Cox regression analysis, PSM, and IPTW analysis. Furthermore, they reflect the severity of CS to some extent. Hyperlactatemia and insulin resistance may underlie the relationship between stress-induced hyperglycemia and poor outcomes in CS patients. They both improve the predictive efficacy of the GCS.
资助项目	Scientific Research Foundation of the Science and Technology Department of Wenzhou City [2022Y0566]; Clinical Research Foundation of the 2nd Affiliated Hospital of Wenzhou Medical University [SAHoWMU-CR2019-01-117]
出版者	BMC
ISSN	1471-2261
卷号	24 期号:1
DOI	10.1186/s12872-024-04138-w
页数	17
WOS类目	Cardiac & Cardiovascular Systems
WOS研究方向	Cardiovascular System & Cardiology
WOS记录号	WOS:001304069400001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	39223451
SCOPUSEID	2-s2.0-85202926551
通讯作者地址	[Ji, Kangting;Xiang, Huaqiang]Wenzhou Med Univ, Affiliated Hosp 2, Dept Cardiol, Xueyuanxi Rd 109, Wenzhou 325027, Zhejiang, Peoples R China. ; [Ji, Kangting;Xiang, Huaqiang]Wenzhou Med Univ, Yuying Childrens Hosp, Xueyuanxi Rd 109, Wenzhou 325027, Zhejiang, Peoples R China.
Scopus学科分类	Cardiology and Cardiovascular Medicine
SCOPUS_ID	SCOPUS_ID:85202926551
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/218758
专题	附属第二医院附属第二医院_耳鼻咽喉科第二临床医学院、附属第二医院、育英儿童医院
通讯作者	Ji, Kangting; Xiang, Huaqiang
作者单位	1.Wenzhou Med Univ, Affiliated Hosp 2, Dept Cardiol, Xueyuanxi Rd 109, Wenzhou 325027, Zhejiang, Peoples R China; 2.Wenzhou Med Univ, Yuying Childrens Hosp, Xueyuanxi Rd 109, Wenzhou 325027, Zhejiang, Peoples R China
第一作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 耳鼻咽喉科
通讯作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 耳鼻咽喉科
第一作者的第一单位	附属第二医院
推荐引用方式 GB/T 7714	Xu, Qianqian,Wang, Jinsheng,Lin, Zhihui,et al. The glycemic gap as a prognostic indicator in cardiogenic shock: a retrospective cohort study[J]. BMC Cardiovascular Disorders,2024,24(1).
APA	Xu, Qianqian, Wang, Jinsheng, Lin, Zhihui, Song, Dongyan, Ji, Kangting, & Xiang, Huaqiang. (2024). The glycemic gap as a prognostic indicator in cardiogenic shock: a retrospective cohort study. BMC Cardiovascular Disorders, 24(1).
MLA	Xu, Qianqian,et al."The glycemic gap as a prognostic indicator in cardiogenic shock: a retrospective cohort study".BMC Cardiovascular Disorders 24.1(2024).