Impact of admission-blood-glucose-to-albumin ratio on all-cause mortality and renal prognosis in critical patients with co-ronary artery disease:insights from the MIMIC-Ⅳ database
Yong HONG
Bo-Wen ZHANG
Jing SHI
Ruo-Xin MIN
Ding-Yu WANG
Jiu-Xu KAN
Yun-Long GAO
Lin-Yue PENG
Ming-Lu XU
Ming-Ming WU
Yue LI
Li SHENG
Abstract：BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis, but the impact of admission-blood-glucose-to-albumin ratio (AAR) on adverse outcomes in critical ill coronary artery disease (CAD) patients was not investigated.
METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-Ⅳ database and categorized into quartiles based on their AAR. The primary outcome was 1-year mortality, and secondary endpoints were in-hospital mortality, acute kidney injury (AKI), and renal replacement therapy (RRT). A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients. Kaplan-Meier survival analysis determined differences in endpoints across subgroups.
RESULTS A total of 8360 patients were included. There were 726 patients (8.7％) died in the hospital and 1944 patients (23％) died at 1 year. The incidence of AKI and RRT was 63％ and 4.3％, respectively. High AAR was markedly associated with in-hospital mortality (HR=1.587, P=0.003), 1-year mortality (HR=1.502, P＜0.001), AKI incidence (HR=1.579, P＜0.001), and RRT (HR=1.640, P＜0.016) in CAD patients in the completely adjusted Cox proportional hazard model. Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles. Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.
CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality, 1-year mortality, and adverse renal prognosis in critical CAD patients.
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Publication Date：2025-06-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：15( 563-577 )