AUTHOR=Yin Xinxin , Pan Xin , Zhang Jingyu , Wu Shuo , Cui Weikai , Wang Yuting , Li Chuanbao , Wang Jiali , Chen Yuguo 

TITLE=Impact of admission glucose and 30-day major adverse cardiovascular events on patients with chest pain in an emergency setting: insights from the China EMPACT registry

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1367704

DOI=10.3389/fcvm.2024.1367704

ISSN=2297-055X

ABSTRACT=Objective: Although the association between admission glucose (AG) and major adverse cardiac events (MACE) is well-documented, its relationship with 30-day MACE in patients presenting with cardiac chest pain remains unclarified. This study aims to examine the correlation between AG levels and the incidence of MACE in patients with chest pain in emergency setting.We consecutively enrolled patients who presented to emergency department (ED) for chest pain symptoms within 24 hours from EMPACT cohort in Eastern China (clinicaltrials.gov, Identifier: NCT02536677). The primary outcome was 30-day MACE, including all-cause death, recurrent myocardial infarction (MI), urgent target vessel revascularization, stroke, cardiogenic shock and cardiac arrest (CA). The associations of AG levels with 30-day MACE were analyzed using Kaplan-Meier analysis and cox regression models.Results: Among 1705 patients included, there were 154 (9.03%) cases met the outcome at 30 days. The average age was 65.23 ± 12.66 years, with 1028 (60.29%) being male and 500 (29.33%) having diabetes. The median AG levels was 7.60 mmol/L (interquartile range: 6.30, 10.20). Kaplan-Meier survival analysis revealed significant differences in the 30-day MACE risk (P<0.001 according to the log-rank test). We found the highest AG level (Q4) was associated with increased MACE risk compared to the lowest AG level (adjusted hazard radio [aHR]: 2.14; 95% CI: 1.2-3.815; P=0.010).  Additionally, Q4 level was also associated with increased all-cause death risk (aHR: 3.825; 95% CI: 1.613-9.07; P=0.002) and increased CA risk (aHR: 3.14; 95% CI: 1.251-7.884; P=0.015).Conclusions: Elevated AG level is significantly correlated with a higher incidence of 30-day MACE in patients with acute chest pain. The findings reveal that the importance of managing AG levels to potentially reduce the risk of adverse cardiac events.