The new biomarker that predicts in-hospital mortality in myocardial infarction: glucose/potassium ratio

Emine Kadıoğlu, Serhat Karaman, Demet Acar, Emine Doğan, Nazlı Karakus Kenan, Asiye Muminat Cap, Emin Fatih Vişneci, Yavuz Yılmaz
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Abstract

Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department. Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented. Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21). Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.
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预测心肌梗死院内死亡率的新生物标志物:葡萄糖/钾比率
目的:急性心肌梗死(AMI)仍是心血管疾病死亡的主要原因之一。然而,用于预测短期死亡率的参数却很有限。葡萄糖-钾比值(GPR)是最近使用的一种新生物标志物。本研究旨在探讨 GPR 在预测急诊科诊断为急性心肌梗死患者的短期死亡率方面的作用:这项回顾性队列研究在 2022 年 1 月 1 日至 2022 年 6 月 30 日期间进行,研究对象包括经 IRB(机构审查委员会)批准在医院急诊医疗系统登记的患者。根据纳入标准确定患者,并在医院登记系统中记录其人口统计学数据、实验室检查结果和预后。死亡和非死亡患者之间的数据比较采用学生 t 检验。相关性分析采用斯皮尔曼相关系数。建立了二元逻辑回归模型以确定预测参数,并给出了几率比和 95% 的置信区间 (CI):研究共纳入了 665 名确诊为 AMI 的患者,其中 75.9% 为男性,平均年龄为(62.14±11.62)岁。共有 6.6% 的患者在住院期间因各种原因死亡。对已死亡的急性心肌梗死患者的化验值进行检查后发现,血糖、尿素、肌酐、白细胞、中性粒细胞、淋巴细胞、肌钙蛋白、ckmb 和乳酸盐水平均有统计学意义的显著增加。采用单变量逻辑回归分析了 GPR、NLR、PLR、乳酸和肌钙蛋白水平对院内死亡率的影响。结果发现,GPR(95% CI 1.015-1.036,p=0.000)、肌钙蛋白(95% CI 1.001-1.001,p=0.000)和乳酸盐(95% CI 1.437-1.908,p=0.000)是与急性心肌梗死患者死亡率相关的最重要因素。比较了预测急性心肌梗死患者院内死亡率的能力,发现 GPR 的预测能力高于心肌损伤的生物标志物肌钙蛋白(AUC:0.729;P=0.000;灵敏度:70%;特异度:70%;临界值:38.21):结论:GPR作为一种新的、廉价的生物标志物,可用于确定AMI患者的院内死亡率。该指数的预测能力优于肌钙蛋白、NLR 和 PLR,但弱于乳酸。
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