Leuko-Glycemic Index in the Prognosis of Acute Myocardial Infarction; a Cohort Study on Coronary Angiography and Angioplasty Registry
Archives of Academic Emergency Medicine,
Vol. 11 No. 1 (2023),
15 Aban 2022
,
Page e63
https://doi.org/10.22037/aaem.v11i1.2085
Abstract
Introduction: The leuko-glycemic index (LGI), a combined index of patient leukocyte counts and blood glucose levels, has been shown to predict the prognosis of myocardial infarction (MI) patients. Our study aims to investigate the performance of LGI in prediction of outcomes in a population of diabetic and non-diabetic MI patients.
Methods: This observational registry-based cohort study was performed on acute myocardial infarction (AMI) patients. Participants were sub-grouped according to their diabetes status and the calculated optimal LGI cut-off value. The outcomes of the study were the length of hospital stay, and in-hospital and 30-day mortality.
Results: A total of 296 AMI (112 diabetic and 184 non-diabetic) patients were included in the study. The optimal cut-off value of LGI in the diabetic and non-diabetic groups was calculated as 2970.4 mg/dl.mm3 and 2249.4 mg/dl.mm3, respectively. High LGI was associated with increased hospital admission duration in non-diabetic patients (p = 0.017). The area under the curve (AUC) of LGI for prediction of in-hospital mortality was 0.93 (95% CI: 0.87 to 1.00) in the diabetic group and 0.92 (95% CI: 0.85 to 0.99) in the non-diabetic group. LGI had a sensitivity and specificity of 90.00%, and 93.14% in prediction of in-hospital mortality in the diabetic group compared to 77.77% and 90.85% in the non-diabetic group. We observed 4 post-discharge mortalities in our patient group.
Conclusion: Our study demonstrated that higher LGI predicts in-hospital mortality in both diabetic and non-diabetic patients, while the length of hospital stay was only predicted by LGI levels in non-diabetic patients.
- Leuko-glycemic index
- LGI
- Acute myocardial infarction
- Risk stratification
How to Cite
References
Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1736-88.
Zhao D. Epidemiological Features of Cardiovascular Disease in Asia. JACC Asia. 2021;1(1):1-13.
Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi S, AlKatheeri R, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020;12(7):e9349.
Wang XY, Zhang F, Zhang C, Zheng LR, Yang J. The Biomarkers for Acute Myocardial Infarction and Heart Failure. Biomed Res Int. 2020;2020:2018035.
Chen Y, Tao Y, Zhang L, Xu W, Zhou X. Diagnostic and prognostic value of biomarkers in acute myocardial infarction. Postgrad Med J. 2019;95(1122):210-6.
Fang L, Moore XL, Dart AM, Wang LM. Systemic inflammatory response following acute myocardial infarction. J Geriatr Cardiol. 2015;12(3):305-12.
Seropian IM, Sonnino C, Van Tassell BW, Biasucci LM, Abbate A. Inflammatory markers in ST-elevation acute myocardial infarction. Eur Heart J Acute Cardiovasc Care. 2016;5(4):382-95.
Hirschson Prado A, Higa C, Merlo P, Domine E, Blanco P, Vazquez G. Prognostic Value of the leuko-glycemic Index in Acute Myocardial Infarction. results from the SCAr Multicenter registry. Rev Argent Cardiol. 2014;82(6):500-5.
Quiroga W, Conci E, Zelaya F, Isa M, Pacheco G, Sala J. [Estratificación del riesgo en el infarto agudo de miocardio según el índice leucoglucémico.¿ El Killip-Kimball de laboratorio]. Rev Fed Arg Cardiol. 2010;39(1):29-34. Spanish.
Chermiti I, Ghazal H, Dimassi R, Mahdhoui S, Gnena H, Chiboub S, et al. Prognostic Value of Leuko-glycemic Index in ST Segment Elevation Myocardial Infarction. JEM. 2017;53(3):435.
Cañas ESV, Sanchez MMH, Olalde JAG, de Sarachaga AJ, Rodríguez ALB, Mas RNM, et al. Neutrophil-lymphocyte and leuko-glycemic indices as predictive markers for ventilatory support in patients with Guillain-Barre syndrome. Arch Neurocien [Internet]. 2023;28(2) (Jan. 2023)
León-Aliz E, Moreno-Martínez FL, Pérez-Fernández GA, Vega-Fleites LF, Rabassa-López-Calleja MA. [Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial infarction]. Clin Investig Arterioscler. 2014;26(4):168-75. Spanish.
Seoane LA, Burgos L, Espinoza JC, Furmento JF, Benzadón MN, Vrancic JM, et al. Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting. Braz J Cardiovasc Surg. 2021;36(4):484-91.
Sadeghi R, Dizaji SR, Vazirizadeh-Mahabadi M, Sarveazad A, Forouzannia SA. Prognostic Value of The Leuko-Glycemic Index in Acute Myocardial Infarction; a Systematic Review and Meta-Analysis. AAEM. 2023;11(1):e25
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). Circulation. 2018;138(20):e618-e51.
Qi LY, Liu HX, Cheng LC, Luo Y, Yang SQ, Chen X, et al. Prognostic Value of the Leuko-Glycemic Index in Acute Myocardial Infarction Patients with or without Diabetes. Diabetes Metab Syndr Obes. 2022;15:1725-36.
Barron HV, Harr SD, Radford MJ, Wang Y, Krumholz HM. The association between white blood cell count and acute myocardial infarction mortality in patients > or =65 years of age: findings from the cooperative cardiovascular project. J Am Coll Cardiol. 2001;38(6):1654-61.
Meissner J, Irfan A, Twerenbold R, Mueller S, Reiter M, Haaf P, et al. Use of neutrophil count in early diagnosis and risk stratification of AMI. Am J Med. 2011;124(6):534-42.
Deckers JW, van Domburg RT, Akkerhuis M, Nauta ST. Relation of admission glucose levels, short- and long-term (20-year) mortality after acute myocardial infarction. Am J Cardiol. 2013;112(9):1306-10.
Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D, et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009;373(9677):1765-72.
Ruparelia N, Chai JT, Fisher EA, Choudhury RP. Inflammatory processes in cardiovascular disease: a route to targeted therapies. Nat Rev Cardiol. 2017;14(3):133-44.
Kounis NG, Soufras GD, Tsigkas G, Hahalis G. White blood cell counts, leukocyte ratios, and eosinophils as inflammatory markers in patients with coronary artery disease. Clin Appl Thromb Hemost. 2015;21(2):139-43.
Yang J, Zheng Y, Li C, Gao J, Meng X, Zhang K, et al. The Impact of the Stress Hyperglycemia Ratio on Short-term and Long-term Poor Prognosis in Patients With Acute Coronary Syndrome: Insight From a Large Cohort Study in Asia. Diabetes Care. 2022;45(4):947-56.
Ladeira RT, Baracioli LM, Faulin TE, Abdalla DS, Seydell TM, Maranhão RC, et al. Unrecognized diabetes and myocardial necrosis: predictors of hyperglycemia in myocardial infarction. Arq Bras Cardiol. 2013;100(5):404-11.
Cuesta-Mero PL, García-Romo LA, Villacres-López ÁD. Leukoglucemic index as a prognostic marker for complications in patients with acute myocardial infarction. Rev. Colomb. de Cardiol. 2021;28(2):119-27.
Padilla-Cueto D, Hernández-Negrín H, Ramírez-Gómez JI, Pérez-Valdivia A, Cárdenas-Sánchez AL, Alfonso-Izquierdo A. The leucoglycaemic index is a predictor of one-year all-cause mortality in Cuban patients with ST-segment elevation acute myocardial infarction. CorSalud. 2019;11(1):21-9.
- Abstract Viewed: 350 times
- pdf Downloaded: 430 times
