Effect of acute and chronic glycemic ratio on the prognostic assessment in vulnerable phase of patients with acute heart failure
10.3760/cma.j.cn115455-20221212-01090
- VernacularTitle:急性慢性血糖比值对急性心力衰竭患者出院后易损期不良预后的评估价值
- Author:
Shulin SHAO
1
;
Xiyun QIAN
Author Information
1. 南京市浦口区中医院检验科，南京 211800
- Keywords:
Acute heart failure;
Vulnerable phase;
Acute and chronic glycemic ratio;
Prognosis
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(2):153-157
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of acute and chronic glycemic ratio on the prognostic assessment in vulnerable phase of patients with acute heart failure (AHF).Methods:The clinical data of 98 AHF patients who treatment in Nanjing Pukou Hospital of Traditional Chinese Medicine from May 2019 to May 2022 were collected retrospectively, the patients were followed up for 3 months, according to whether adverse events occurred in the vulnerable phase, the patients were divided into adverse prognosis group (31 cases) and non-adverse prognosis group(67 cases). The acute and chronic glycemic ratio was calculated based on the intravenous blood glucose and glycosylated hemoglobin (HbA 1c). The influencing factors of adverse prognosis of AHF patients in vulnerable phase was analyzed by Cox risk proportion model, the predictive value of acute and chronic glycemic ratio on adverse prognosis was evaluated by receiver operating characteristic (ROC) curve. Kaplan-Meier method was used to draw the survival curve and compared the risk of adverse prognosis in patients with different acute and chronic glycemic ratio. Results:The severity of cardiac function grading as well as total cholesterol, urea nitrogen, blood glucose, acute and chronic glycemic ratio, highly sensitive C-reactive protein (hs-CPR), left ventricular anteroposterior diameter, right atrial anteroposterior diameter in the adverse prognosis group were higher than those in the non-adverse prognosis group: (3.88 ± 0.18)mmol/L vs. (3.76 ± 0.24) mmol/L, (9.39 ± 1.07) mmol/L vs. (8.68 ± 1.79) mmol/L, (10.49 ± 2.20) mmol/L vs. (7.64 ± 1.57)mmol/L, 1.37 ± 0.47 vs. 1.04 ± 0.35, (3.85 ± 0.36) mg/L vs. (3.68 ± 0.28) mg/L, (48.47 ± 7.86) mm vs. (45.37 ± 3.56) mm, (47.18 ± 5.04) mm vs. (44.05 ± 6.11) mm, there were statistical differences ( P<0.05). Cox multivariate analysis showed that hypertension, white blood cell count, blood sodium, low density lipoprotein cholesterol, acute and chronic glycemic ratio were the risk factors for adverse prognosis in vulnerable phase ( P<0.05). The area under the curve of acute and chronic glycemic ratio for predicting adverse prognosis in vulnerable phase was 0.718 (95 CI: 0.618 - 0.805, P<0.01), with specificity of 62.7%, sensitivity of 77.4%, and cut-off value of 1.07. According to the cut-off value of acute and chronic glycemic ratio, the patients were divided into acute and chronic glycemic ratio>1.07 group (43 cases), acute and chronic glycemic ratio≤ 1.07 group (55 cases), there was a statistically significant difference in the event free survival between the two groups ( P<0.01). Conclusions:AHF patients who with high acute and chronic glycemic ratio have a high risk of adverse prognosis in the vulnerable phase, which can be used as a predictor of the prognosis patients.
