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Background <p>The 2023 Guideline for the Management of Patients with Chronic Coronary Artery Disease (CAD) highlights that CAD remains the leading cause of morbidity and mortality, even in patients with well-controlled glycemia. This study aimed to investigate the impact of residual glucose metabolism, measured via hemoglobin glycation index (HGI), on long-term clinical outcomes of patients with multivessel CAD.</p> Methods <p>1718 patients with multivessel CAD from the Medicine, Angioplasty or Surgery Registry were included. The primary and secondary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) at 5 years after enrollment, respectively. Cox proportional hazards and modified Poisson regression models were used to explore associations between HGI and long-term clinical outcomes.</p> Results <p>During a median follow-up of 5.00 years, the all-cause mortality and incidence of MACCE were 7.68% and 24.74%, respectively. In fully adjusted models, low HGI significantly increased risks of all-cause mortality (HR=1.909, 95% CI: 1.061-3.565) and MACCE (PR=1.428, 95% CI: 1.077-1.894) compared with high HGI, and an inverse J-shaped nonlinear relationship between HGI and the risk of all-cause mortality. Furthermore, HbA1c control status moderated the association between HGI and all-cause mortality (P interaction &lt; 0.010), reflecting linear negative relationship between HGI and all-cause mortality in patients with well-controlled glycemia and U-shaped relationship in those with sub-optimally controlled glycemia.</p> Conclusions <p>HGI was significantly associated with long-term clinical outcomes in patients with multivessel CAD, independent of HbA1c, suggesting that enhanced monitoring of residual glucose metabolism might be beneficial in patients with multivessel CAD.</p>

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Residual glucose metabolism and Long-Term clinical outcomes in multivessel coronary artery disease: A cohort study

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Aijun You,
  • Mengshi Li,
  • Jianhua Xue,
  • Xi Chen,
  • Qing Zhang,
  • Tianyi Zhu,
  • Liang Zheng,
  • Li Zhang

摘要

Background

The 2023 Guideline for the Management of Patients with Chronic Coronary Artery Disease (CAD) highlights that CAD remains the leading cause of morbidity and mortality, even in patients with well-controlled glycemia. This study aimed to investigate the impact of residual glucose metabolism, measured via hemoglobin glycation index (HGI), on long-term clinical outcomes of patients with multivessel CAD.

Methods

1718 patients with multivessel CAD from the Medicine, Angioplasty or Surgery Registry were included. The primary and secondary outcomes were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) at 5 years after enrollment, respectively. Cox proportional hazards and modified Poisson regression models were used to explore associations between HGI and long-term clinical outcomes.

Results

During a median follow-up of 5.00 years, the all-cause mortality and incidence of MACCE were 7.68% and 24.74%, respectively. In fully adjusted models, low HGI significantly increased risks of all-cause mortality (HR=1.909, 95% CI: 1.061-3.565) and MACCE (PR=1.428, 95% CI: 1.077-1.894) compared with high HGI, and an inverse J-shaped nonlinear relationship between HGI and the risk of all-cause mortality. Furthermore, HbA1c control status moderated the association between HGI and all-cause mortality (P interaction < 0.010), reflecting linear negative relationship between HGI and all-cause mortality in patients with well-controlled glycemia and U-shaped relationship in those with sub-optimally controlled glycemia.

Conclusions

HGI was significantly associated with long-term clinical outcomes in patients with multivessel CAD, independent of HbA1c, suggesting that enhanced monitoring of residual glucose metabolism might be beneficial in patients with multivessel CAD.