Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion

Background and Objectives: Chronic total occlusion (CTO) is a complex lesion of coronary artery disease (CAD) with a detection rate of approximately 25% on coronary angiography. CTO patients generally experience poor quality of life and prognosis. This study aims to evaluate the association between...

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Main Authors: Wenjie Chen, Yiming Liu, Yuchen Shi, Jinghua Liu
Format: Article
Language:English
Published: MDPI AG 2024-08-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/11/9/261
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author Wenjie Chen
Yiming Liu
Yuchen Shi
Jinghua Liu
author_facet Wenjie Chen
Yiming Liu
Yuchen Shi
Jinghua Liu
author_sort Wenjie Chen
collection DOAJ
description Background and Objectives: Chronic total occlusion (CTO) is a complex lesion of coronary artery disease (CAD) with a detection rate of approximately 25% on coronary angiography. CTO patients generally experience poor quality of life and prognosis. This study aims to evaluate the association between the estimated glucose disposal rate (eGDR), a surrogate marker for insulin resistance (IR), and the prognosis of CTO PCI patients, as well as to investigate the potential role of the systemic immune-inflammation index (SII) in this process. Methods: We retrospectively included 1482 non-diabetic patients who underwent successful CTO PCI at Anzhen Hospital between January 2018 and December 2021. The primary endpoint was major adverse cardiovascular events (MACEs). Clinical characteristics, biochemical markers, and interventional records were collected, and the eGDR and SII were calculated. Cox regression, restricted cubic splines (RCSs), receiver operating characteristic (ROC) analysis, and Kaplan–Meier curves were used to assess associations. Results: MACEs occurred in 158 patients (10.67%). Patients with MACEs had lower eGDR and higher SII levels. A high eGDR significantly reduced MACE risk (Q4 vs. Q1: HR 0.06, 95% CI 0.03–0.12), while a high SII increased it (Q4 vs. Q1: HR 3.32, 95% CI 1.78–6.33). The combination of low eGDRs and high SIIs predicted the highest MACE risk (HR 4.36, 95% CI 2.71–6.01). The SII partially mediated the relationship between eGDR and MACEs. Conclusions: A low eGDR and high SII are significant predictors of poor prognosis in non-diabetic CTO PCI patients. Combining the eGDR and the SII provides a comprehensive assessment for better predicting cardiovascular outcomes.
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spelling doaj-art-18790928456447ed916cf498fbff87d82025-08-20T01:55:34ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-08-0111926110.3390/jcdd11090261Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total OcclusionWenjie Chen0Yiming Liu1Yuchen Shi2Jinghua Liu3Center for Coronary Artery Disease (CCAD), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, ChinaCenter for Coronary Artery Disease (CCAD), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, ChinaCenter for Coronary Artery Disease (CCAD), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, ChinaCenter for Coronary Artery Disease (CCAD), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, ChinaBackground and Objectives: Chronic total occlusion (CTO) is a complex lesion of coronary artery disease (CAD) with a detection rate of approximately 25% on coronary angiography. CTO patients generally experience poor quality of life and prognosis. This study aims to evaluate the association between the estimated glucose disposal rate (eGDR), a surrogate marker for insulin resistance (IR), and the prognosis of CTO PCI patients, as well as to investigate the potential role of the systemic immune-inflammation index (SII) in this process. Methods: We retrospectively included 1482 non-diabetic patients who underwent successful CTO PCI at Anzhen Hospital between January 2018 and December 2021. The primary endpoint was major adverse cardiovascular events (MACEs). Clinical characteristics, biochemical markers, and interventional records were collected, and the eGDR and SII were calculated. Cox regression, restricted cubic splines (RCSs), receiver operating characteristic (ROC) analysis, and Kaplan–Meier curves were used to assess associations. Results: MACEs occurred in 158 patients (10.67%). Patients with MACEs had lower eGDR and higher SII levels. A high eGDR significantly reduced MACE risk (Q4 vs. Q1: HR 0.06, 95% CI 0.03–0.12), while a high SII increased it (Q4 vs. Q1: HR 3.32, 95% CI 1.78–6.33). The combination of low eGDRs and high SIIs predicted the highest MACE risk (HR 4.36, 95% CI 2.71–6.01). The SII partially mediated the relationship between eGDR and MACEs. Conclusions: A low eGDR and high SII are significant predictors of poor prognosis in non-diabetic CTO PCI patients. Combining the eGDR and the SII provides a comprehensive assessment for better predicting cardiovascular outcomes.https://www.mdpi.com/2308-3425/11/9/261chronic total occlusion (CTO)percutaneous coronary intervention (PCI)estimated glucose disposal rate (eGDR)systemic immune-inflammation index (SII)major adverse cardiovascular events (MACEs)
spellingShingle Wenjie Chen
Yiming Liu
Yuchen Shi
Jinghua Liu
Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
Journal of Cardiovascular Development and Disease
chronic total occlusion (CTO)
percutaneous coronary intervention (PCI)
estimated glucose disposal rate (eGDR)
systemic immune-inflammation index (SII)
major adverse cardiovascular events (MACEs)
title Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
title_full Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
title_fullStr Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
title_full_unstemmed Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
title_short Prognostic Value of Estimated Glucose Disposal Rate and Systemic Immune-Inflammation Index in Non-Diabetic Patients Undergoing PCI for Chronic Total Occlusion
title_sort prognostic value of estimated glucose disposal rate and systemic immune inflammation index in non diabetic patients undergoing pci for chronic total occlusion
topic chronic total occlusion (CTO)
percutaneous coronary intervention (PCI)
estimated glucose disposal rate (eGDR)
systemic immune-inflammation index (SII)
major adverse cardiovascular events (MACEs)
url https://www.mdpi.com/2308-3425/11/9/261
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