Prognostic Value of Estimated Glucose Disposal Rate in Patients with Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention

Chi Liu^1,†, Qi Zhao^2,†, Xiaoteng Ma¹, Yujing Cheng¹, Yan Sun¹, Dai Zhang¹, Yujie Zhou^1,*, Xiaoli Liu^1,*

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¹ Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, 100029 Beijing, China

² Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 100052 Beijing, China

^*Correspondence: azzyj12@163.com (Yujie Zhou); liuxl9881@163.com (Xiaoli Liu)
^†These authors contributed equally.
Academic Editor: Gabriele Fragasso

Rev. Cardiovasc. Med. 2023, 24(1), 2; https://doi.org/10.31083/j.rcm2401002

Submitted: 2 September 2022 | Revised: 19 October 2022 | Accepted: 25 October 2022 | Published: 3 January 2023

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Estimated glucose disposal rate (eGDR) is highly associated with all-cause mortality in type 2 diabetes mellitus (T2DM) cases undergoing coronary artery bypass grafting (CABG). Nevertheless, eGDR’s prognostic value in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) following percutaneous coronary intervention (PCI) remains unknown. Methods: The population of this retrospective cohort study comprised NSTE-ACS patients administered PCI in Beijing Anzhen Hospital between January and December 2015. The primary endpoint was major adverse cardiac and cerebral events (MACCEs). eGDR was calculated based on waist circumference (WC) (eGDR ${}_{\text{WC}}$ ) or body mass index (BMI) (eGDR ${}_{\text{BMI}}$ ). Results: Totally 2308 participants were included, and the mean follow-up time was 41.06 months. The incidence of MACCEs was markedly increased with decreasing eGDR. Multivariable analysis showed hazard ratios (HRs) for eGDR ${}_{\text{WC}}$ and eGDR ${}_{\text{BMI}}$ of 1.152 (95% confidence interval [CI] 1.088–1.219; p $<$ 0.001) and 0.998 (95% CI 0.936–1.064; p = 0.957), respectively. Addition of eGDR ${}_{\text{WC}}$ to a model that included currently recognized cardiovascular risk factors markedly enhanced its predictive power compared with the baseline model (Harrell’s C-index, eGDR ${}_{\text{WC}}$ versus Baseline model, 0.778 versus 0.768, p = 0.003; continuous net reclassification improvement (continuous-NRI) of 0.125, p $<$ 0.001; integrated discrimination improvement (IDI) of 0.016, p $<$ 0.001). Conclusions: Low eGDR independently predicts low survival of NSTE-ACS cases who underwent PCI.

Keywords

estimated glucose disposal rate

non-ST-segment elevation acute coronary syndrome

percutaneous coronary intervention

prognosis

Funding

2017YFC0908800/National Key Research and Development Program of China

SML20180601/Beijing Municipal Administration of Hospitals “Mission plan”

Figures

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