Prognostic value of estimated glucose disposal rate in non-ST-segment elevation acute coronary syndrome cases administered percutaneous coronary intervention

Background: Estimated glucose disposal rate (eGDR) is highly associated with all-cause mortality in type 2 diabetes mellitus (T2DM) cases administered coronary artery bypass grafting (CABG). However, the predictive ability of eGDR for poor outcome in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) cases diagnosed by percutaneous coronary intervention (PCI) remains unknown. Methods: : Totally 2308 NSTE-ACS patients administered PCI at Beijing Anzhen Hospital from January to December 2015 were enrolled in this study. Major adverse cardiac and cerebral events (MACCEs) were considered the primary endpoint. eGDR was calculated by waist circumference (WC) (eGDR WC ) or body mass index (BMI) (eGDR BMI ). Results: : The incidence of MACCEs was markedly higher in cases with low eGDR compared with the high eGDR group. Multivariable analysis showed hazard ratios (HRs) for eGDR WC and eGDR BMI of 1.152 (95% confidence interval [CI] 1.088-1.219; P <0.001) and 0.998 (95%CI 0.936-1.064; P =0.957). Addition of eGDR WC to a model that includes currently recognized cardiovascular risk factors markedly enhanced its predictive power (Harrell’s C-index, eGDR WC versus Baseline model, 0.778 versus 0.768, P =0.003; continuous net reclassification improvement (continuous-NRI) 0.125, P <0.001; integrated discrimination improvement (IDI) 0.016, P <0.001). Conclusion: Low eGDR independently predicts adverse outcome in NSTE-ACS cases administered PCI.