Impact of admission-blood-glucose-to-albumin ratio on all-cause mortality and renal prognosis in critical patients with coronary artery disease: insights from the MIMIC-IV database.
- Author:
Yong HONG
1
;
Bo-Wen ZHANG
1
;
Jing SHI
1
;
Ruo-Xin MIN
1
;
Ding-Yu WANG
1
;
Jiu-Xu KAN
1
;
Yun-Long GAO
1
;
Lin-Yue PENG
1
;
Ming-Lu XU
1
;
Ming-Ming WU
1
;
Yue LI
1
;
Li SHENG
1
Author Information
- Publication Type:Journal Article
- From: Journal of Geriatric Cardiology 2025;22(6):563-577
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Blood glucose and serum albumin have been associated with cardiovascular disease prognosis, but the impact of admission-blood-glucose-to-albumin ratio (AAR) on adverse outcomes in critical ill coronary artery disease (CAD) patients was not investigated.
METHODS:Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR. The primary outcome was 1-year mortality, and secondary endpoints were in-hospital mortality, acute kidney injury (AKI), and renal replacement therapy (RRT). A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients. Kaplan-Meier survival analysis determined differences in endpoints across subgroups.
RESULTS:A total of 8360 patients were included. There were 726 patients (8.7%) died in the hospital and 1944 patients (23%) died at 1 year. The incidence of AKI and RRT was 63% and 4.3%, respectively. High AAR was markedly associated with in-hospital mortality (HR = 1.587, P = 0.003), 1-year mortality (HR = 1.502, P < 0.001), AKI incidence (HR = 1.579, P < 0.001), and RRT (HR = 1.640, P < 0.016) in CAD patients in the completely adjusted Cox proportional hazard model. Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles. Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.
CONCLUSIONS:The results highlight that AAR may be a potential indicator for assessing in-hospital mortality, 1-year mortality, and adverse renal prognosis in critical CAD patients.
