ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

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Original Article
The new biomarker that predicts in-hospital mortality in myocardial infarction: glucose/potassium ratio
Abstract
Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department.
Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented.
Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21).
Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.

Keywords : Acute myocardial infarction, glucose-potassium ratio, short-term mortality

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1. Xiang L, Wang M, You T, Jiao Y, Chen J, Xu W. Prognostic value of ventricularwall motion score and global registry of acute coronary events score inpatients with acute myocardial infarction. Am J Med Sci. 2017;354(1):27-32.
2. Soylu K, Gedikli Ö, Dagasan G, et al. Neutrophil-to-lymphocyte ratio predictscoronary artery lesion complexity and mortality after non-ST-segmentelevation acute coronary syndrome. Rev Port Cardiol. 2015;34(7-8):465-471.
3. Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil tolymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010;106(4):470-476.
4. Wada H, Dohi T, Miyauchi K, et al. Pre-procedural neutrophil-to-lymphocyteratio and long-term cardiac outcomes after percutaneous coronaryintervention for stable coronary artery disease. Atherosclerosis. 2017;265:35-40.
5. Libby P, Tabas I, Fredman G, Fisher EA. Inflammation and its resolution asdeterminants of acute coronary syndromes. Circ Res. 2014;114(12):1867-1879.
6. Libby P, Ridker PM, Hansson GK. Leducq transatlantic network on a:inflammation in atherosclerosis: from pathophysiology to practice. J AmColl Cardiol. 2009;54(23):2129-2138.
7. Donia T, Khamis A. Management of oxidative stress and inflammationin cardiovascular diseases: mechanisms and challenges. Environ SciPollut Res Int. 2021;(28):34121-34153.
8. Zhang DP, Mao XF, Wu TT, et al. The fibrinogen-to-albumin ratio isassociated with outcomes in patients with coronary artery disease whounderwent percutaneous coronary intervention. Clin Appl Thromb Hemost.2020;26:1076029620933008.
9. Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabeticcritically ill patients. Best Pract Res Clin Endocrinol Metab. 2011;25(5):813-824.
10. Marik PE, Bellomo R. Stress hyperglycemia: an essential survival response!Crit Care. 2013;17(2):1-7.
11. Matano F, Fujiki Y, Mizunari T, et al. Serum glucose and potassium ratioas risk factors for cerebral vasospasm after aneurysmal subarachnoidhemorrhage. J Stroke Cerebrovasc Dis. 2019;28(7):1951-1957.
12. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia andincreased risk of death after myocardial infarction in patients with andwithout diabetes: a systematic overview. Lancet. 2000;355(9206):773-778.
13. Deedwania P, Kosiborod M, Barrett E, et al. Hyperglycemia and acutecoronary syndrome: a scientific statement from the american heartassociation diabetes committee of the council on nutrition, physical activity,and metabolism. Circulation. 2008;117(12):1610-1619.
14. Wahab NN, Cowden EA, Pearce NJ, et al. Is blood glucose an independentpredictor of mortality in acute myocardial infarction in the thrombolyticera? J Am Coll Cardiol. 2002;40(10):1748-1754.
15. Bolk J, van der Ploeg TJ, Cornel JH, Arnold AER, Sepers J, Umans VAWM.Impaired glucose metabolism predicts mortality after a myocardialinfarction. Int J Cardiol. 2001;79(2-3):207-214.
16. Leor J, Goldbourt U, Reicher-Reiss H, Kaplinsky E, Behar S. Cardiogenic shockcomplicating acute myocardial infarction in patients without heart failure onadmission: incidence, risk factors, and outcome. Am J Med. 1993;94(3):265-273.
17. Kosiborod M, Rathore SS, Inzucchi SE, et al. Admission glucose andmortality in elderly patients hospitalized with acute myocardial infarction:implications for patients with and without recognized diabetes. Circulation.2005;111(23):3078-3086.
18. Tsuchida K, Nishida K, Soda S, et al. Impact of glycemic variability onmyocardial infarct size in patients with ST-segment elevation myocardialinfarction: quantitative assessment of left ventricular wall motion severity.Cardiovasc Interv Ther. 2019;34(2):122-130.
19. Malmberg K, Rydén L, Efendic S, et al. Randomized trial of insulin-glucoseinfusion followed by subcutaneous insulin treatment in diabetic patientswith acute myocardial infarction (DIGAMI study): effects on mortality at 1year. J Am Coll Cardiol. 1995;26(1):57-65.
20. Melek FE, Baroncini LAV, Repka JCD, Nascimento CS, Précoma DB.Oxidative stress and inflammatory response increase during coronaryartery bypass grafting with extracorporeal circulation. Braz J CardiovascSurg. 2012;27(1):61-65.
21. Sadiq SMM, Dakhil MA, Dakhil ZA. Effect of diabetes on laboratorymarkers in patients with non-ST elevation acute coronary syndromes. J PhysConf Ser. 2021;1818(1):012040.
22. Matano F, Fujiki Y, Mizunari T, et al. Serum glucose and potassium ratioas risk factors for cerebral vasospasm after aneurysmal subarachnoidhemorrhage. J Stroke Cerebrovasc Dis. 2019;28(7):1951-1957.
23. Wu XY, Zhuang YK, Cai Y, et al. Serum glucose and potassium ratio as apredictive factor for prognosis of acute intracerebral hemorrhage. J Int MedRes. 2021;49(4):030006052110096.
24. Fujiki Y, Matano F, Mizunari T, et al. Serum glucose/potassium ratio as aclinical risk factor for aneurysmal subarachnoid hemorrhage. J Neurosurg.2018;129(4):870-875.
Article available in :
Volume 2, Issue 1, 2024
Page : 6-10
https://doi.org/10.51271/ICJEM-0027
Article Information
Received : 07 Ara 2023
Accepted : 08 Oca 2024
Published : 17 Mar 2024
Corresponding Author :

Emine Kadıoğlu: Health Ministry of Turkish Republic Konya City Hospital, Emergency Medicine Department, Konya, Turkey

[email protected]
Citation : Kadıoğlu E, Karaman S, Acar D, et al. The new biomarker that predicts in-hospital mortality in myocardial infarction: glucose/potassium ratio. Intercont J Emerg Med. 2024;2(1):6-10.

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