Fasting plasma glucose level and in-hospital cardiac arrest in patients with acute coronary syndrome: findings from the CCC-ACS project

Kangning Han; Xia Li; Mengmeng Li; Tong Liu; Fang Liu; Jie Yang; Shuyu Jin; Jing Liu; Jun Liu; Yongchen Hao; Jing Lin; Chenxi Jiang; Ribo Tang; Jianzeng Dong; Dong Zhao; Deyong Long; Changsheng Ma

doi:10.1080/07853890.2024.2419546

Fasting plasma glucose level and in-hospital cardiac arrest in patients with acute coronary syndrome: findings from the CCC-ACS project

Ann Med. 2024 Dec;56(1):2419546. doi: 10.1080/07853890.2024.2419546. Epub 2024 Nov 5.

Authors

Kangning Han¹, Xia Li², Mengmeng Li¹, Tong Liu¹, Fang Liu¹, Jie Yang¹, Shuyu Jin¹, Jing Liu³, Jun Liu³, Yongchen Hao³, Jing Lin¹, Chenxi Jiang¹, Ribo Tang¹, Jianzeng Dong¹, Dong Zhao³, Deyong Long¹, Changsheng Ma¹

Affiliations

¹ Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.
² Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Australia.
³ Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China.

Abstract

Background: The prognosis of patients with coronary artery disease is adversely affected by elevated fasting plasma glucose (FPG) levels. However, the relationship between FPG levels and in-hospital cardiac arrest (IHCA) remains unclear.

Objectives: The objective of this study was to investigate the association between FPG levels and IHCA in patients diagnosed with acute coronary syndrome (ACS).

Methods: Data from a total of 31,726 ACS patients fitted with inclusion and exclusion criteria across 241 hospitals in the Improving Care for Cardiovascular Disease in China-ACS project from November 2014 to July 2019 were collected. Different logistic regression models were utilized to examine the associations of FPG levels with IHCA. Sensitivity analyses were then conducted to assess the robustness of the findings. Marginal effect analyses were also employed to evaluate the impact of different therapies.

Results: A total of 335 cases of IHCA and 293 in-hospital mortality were recorded throughout the study. A non-linear relationship between FPG levels and IHCA was identified after adjusting for the covariates. Specifically, a significant association was found between elevated FPG levels (≥6.1 mmol/L) and an increased risk of IHCA. These findings remained consistent across different subgroup analyses including both the diabetic and non-diabetic patients. Additionally, the marginal effect analyses revealed that percutaneous coronary intervention could lower the high FPG-related risk.

Conclusions: The study findings showed a positive correlation between FPG levels and a higher incidence of IHCA, irrespective of the presence of diabetes.

Keywords: Fasting plasma glucose; acute coronary syndrome; diabetes; in-hospital cardiac arrest.

Publication types

Multicenter Study

MeSH terms

Acute Coronary Syndrome* / blood
Acute Coronary Syndrome* / epidemiology
Acute Coronary Syndrome* / mortality
Aged
Blood Glucose* / analysis
Blood Glucose* / metabolism
China / epidemiology
Fasting* / blood
Female
Heart Arrest* / blood
Heart Arrest* / epidemiology
Heart Arrest* / mortality
Heart Arrest* / therapy
Hospital Mortality*
Humans
Male
Middle Aged
Percutaneous Coronary Intervention / statistics & numerical data
Prognosis
Risk Factors

Substances

Blood Glucose

Grants and funding

The CCC-ACS project was a collaborative programme of the American Heart Association and the Chinese Society of Cardiology. The American Heart Association received funding from Pfizer and AstraZeneca through an independent grant for learning and change as a quality improvement initiative. This work was also supported by the National Natural Science Foundation of China (82151306 and 82070339) and National Science and Technology Major Project (2023ZD0504200).