Glycemic gap within 24 hrs of admission independently predicts MACE and STEMI: Study

• At 30 days of follow-up, 6.5% deaths and 11.5% MACEs.
• The risk of all-cause mortality (4.0%, 5.6%, 6.5%, and 10.1%) and MACEs (7.3%, 9.6%, 11.4%, and 17.7%) increased remarkably with the elevation of GAPmean.
• Receiver operating characteristic curve analysis showed that GAPmean was better than admission blood sugar and GAPadm (defined as the difference between ABG and ADAG) for detecting adverse outcomes.
• Multivariate Cox regression analysis demonstrated that increased GAPmean was independently associated with MACEs and all-cause death.
• The hazards ratios for all-cause death in the second, third, and fourth quartiles with the first quartile as the reference were respectively 1.49, 1.58, and 2.11, and the HRs for MACEs were 1.40, 1.60, and 2.17, respectively, which were independent diabetes status.
• Continuous NRI analysis showed that GAPmean significantly improved risk stratification for all-cause mortality and MACEs by 21.6% and 19.8%, respectively.

"The glycemic gap between mean blood glucose level (MGL) within 24 hours after admission and A1c-derived average glucose (ADAG) was linked with 30-day all-cause mortality and MACEs in acute STEMI patients, which was affected by DM status," researchers wrote in their study. "Further, the glycemic gap provided incremental accuracy in STEMI's risk stratification."

To conclude, GAPmean is superior to admission blood sugar and GAPadm for predicting all-cause mortality and MACEs.

Reference:

The "Impact of glycemic gap on 30-day adverse outcomes in patients with acute ST-segment elevation myocardial infarction," was published in Atherosclerosis.

DOI: https://doi.org/10.1016/j.atherosclerosis.2022.10.003