Glycemic Variability Is a Powerful Independent Predictive Factor of Midterm Major Adverse Cardiac Events in Patients With Diabetes With Acute Coronary Syndrome
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OBJECTIVE: Acute glucose fluctuations are associated with hypoglycemia and are emerging risk factors for cardiovascular outcomes. However, the relationship between glycemic variability (GV) and the occurrence of midterm major cardiovascular events (MACE) in patients with diabetes remains unclear. This study investigated the prognostic value of GV in patients with diabetes and acute coronary syndrome (ACS). RESEARCH DESIGN AND METHODS: This study included consecutive patients with diabetes and ACS between January 2015 and November 2016. GV was assessed using SD during initial hospitalization. MACE, including new-onset myocardial infarction, acute heart failure, and cardiac death, were recorded. The predictive effects of GV on patient outcomes were analyzed with respect to baseline characteristics and cardiac status. RESULTS: A total of 327 patients with diabetes and ACS were enrolled. MACE occurred in 89 patients (27.2%) during a mean follow-up of 16.9 months. During follow-up, 24 patients (7.3%) died of cardiac causes, 35 (10.7%) had new-onset myocardial infarction, and 30 (9.2%) were hospitalized for acute heart failure. Multivariable logistic regression analysis showed that GV >2.70 mmol/L, a Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score >34, and reduced left ventricular ejection fraction of <40% were independent predictors of MACE, with odds ratios (ORs) of 2.21 (95% CI 1.64–2.98; P < 0.001), 1.88 (1.26–2.82; P = 0.002), and 1.71 (1.14–2.54; P = 0.009), respectively, whereas a Global Registry of Acute Coronary Events (GRACE) risk score >140 was not (OR 1.07 [0.77–1.49]; P = 0.69). CONCLUSIONS: A GV cutoff value of >2.70 mmol/L was the strongest independent predictive factor for midterm MACE in patients with diabetes and ACS.
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In Gerbaud et al, a glycemic variability cut-off of >2.70 mmol/L was the strongest independent predictive factor of MACE (OR 2.21, 1.64-0.98, p<0.001).
“GV cut-off of >2.70 mmol/L was the strongest independent predictive factor of MACE: OR 2.21 (1.64–0.98), p<0.001.”
From Glycemic variability and cardiovascular disease in patients with type 2 diabetes (2021) · cites this paper as [42]
In patients with diabetes and acute coronary syndrome, a glycemic variability cut-off value of >2.70 mmol/L (49 mg/dL) was the strongest independent predictive factor of MACE, including new onset of myocardial infarction, acute heart failure and cardiac death.
“Gerbaud et al42 reported that in patients with diabetes and acute coronary syndrome, a GV cut-off value of >2.70 mmol/L (49 mg/dL) was the strongest independent predictive factor of MACE, including new onset of myocardial infarction, acute heart failure and cardiac death.”
From Glycemic variability and cardiovascular disease in patients with type 2 diabetes (2021) · cites this paper as [42]
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Self-citation
- Authors
- Gerbaud, E., Darier, R., Montaudon, M., Beauvieux, M.-C., Coffin-Boutreux, C., Coste, P., Douard, H., Ouattara, A., & Catargi, B.
- Affiliations
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
- Hôpital Cardiologique du Haut-Lévêque (FR)
- Université de Bordeaux (FR)
- Endocrinology-Nutrition Department, Centre Hospitalier de Périgueux, Périgueux, France
- Corresponding author
- Catargi, Bogdan
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2019-02-06
- Volume
- 42
- Issue
- 4
- Pages
- 674-681
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2914109162
- Cited by
- 138
- References
- 40
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 17 · 2023: 15 · 2022: 23 · 2021: 29 · 2020: 18 · 2019: 9
- FWCI
- 16.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Oskar-Bordeaux (Universite de Bordeaux) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- glycemic variability, acute coronary syndrome, diabetes mellitus, major adverse cardiac events, prognostic factors, SYNTAX score, left ventricular ejection fraction, GRACE risk score, myocardial infarction, acute heart failure, cardiovascular mortality
- MeSH terms
- Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Hospitalization, Humans, Prognosis, Registries, Risk Factors, Diabetes Complications, Acute Coronary Syndrome, Percutaneous Coronary Intervention
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