Integrated metabolic-inflammatory risk assessment: HbA1c/HDL-c and hsCRP-to-albumin ratios synergistically predict major adverse cardiovascular events in post-PCI STEMI patients

作者：Jinyong Huang, Junyi Zhang, Zhonghui Xie, Linjie Li, Meiyan Chen, Yongle Li, Xiangdong Yu, Shaozhuang Dong, Qing Wang, Jun Chen, Qin Yang, Shaopeng Xu · 发表于：Lipids in Health and Disease · 年份：2025 · DOI：10.1186/s12944-025-02707-2 · 被引用次数：5 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Acute Myocardial Infarction Research、Hyperglycemia and glycemic control in critically ill and hospitalized patients

BACKGROUND: This study looked into how predictive in ST-segment elevation myocardial infarction (STEMI) is the high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) as well as glycated hemoglobin to high-density lipoprotein cholesterol (HbA1c/HDL-c) ratio. METHODS: This retrospective cohort research was carried out on 1,177 patients having STEMI who were given percutaneous coronary intervention (PCI). For major adverse cardiovascular events (MACE), the independent and combined predictive values of the HbA1c/HDL-c ratio (threshold ≥ 6.61) and hsCAR (threshold ≥ 0.18) were assessed. MACE was an amalgamation of death from all causes, ischemia-induced revascularization, myocardial infarction not leading to death, heart failure hospitalization, and cerebrovascular events. The team used Cox regression models, causal mediation examination, and receiver operating characteristic curves to assess prognostic performance and mechanistic pathways, and compared them with the Global Registry of Acute Coronary Events (GRACE) risk score. RESULTS: The interquartile range for follow-up was 79 to 672 days, with 461 median days. A raised HbA1c/HDL-c ratio (≥ 6.61) and hsCAR (≥ 0.18) independently predicted MACE, with 1.51 (95% confidence interval [CI]: 1.26-1.81; P < 0.001) as well as 1.84 (95% CI: 1.53-2.21; P = 0.005) hazard ratios (HRs), respectively. Combined use enhanced risk stratification, with the high HbA1c/HDL-c-high hsCAR group showing the highest risk (adjusted HR 2.19, 95% CI:...