TY - JOUR
T1 - Stress Hyperglycemia Drives the Risk of Hospitalization for Chest Pain in Patients With Ischemia and Nonobstructive Coronary Arteries (INOCA)
AU - Mone, Pasquale
AU - Lombardi, Angela
AU - Salemme, Luigi
AU - Cioppa, Angelo
AU - Popusoi, Grigore
AU - Varzideh, Fahimeh
AU - Pansini, Antonella
AU - Jankauskas, Stanislovas S.
AU - Forzano, Imma
AU - Avvisato, Roberta
AU - Wang, Xujun
AU - Tesorio, Tullio
AU - Santulli, Gaetano
N1 - Funding Information:
Funding. The Santulli Laboratory is supported in part by the National Institutes of Health: National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK123259, R01-DK033823), National Heart, Lung, and Blood Institute (R01-HL164772, R01-HL159062, R01-HL146691, T32-HL144456), the National Center for Advancing Translational Sciences (UL1TR002556-06) to G.S., the Diabetes Action Research and Education Foundation (to G.S.), and the Monique Weill-Caulier and Irma T. Hirschl Trusts (to G.S.). F.V. is supported in part by a postdoctoral fellowship of the American Heart Association (AHA-22POST995561). S.S.J. is supported in part by a postdoctoral fellowship of the American Heart Association (AHA-21POST836407). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. P.M., T.T., and G.S. designed the study, drafted the manuscript, approved its final version, and made the decision to submit and publish the manuscript. A.L., A.P., and X.W. analyzed data, revised the manuscript’s intellectual content, and approved the final version. L.S., A.C., G.P., and T.T. acquired the data, revised the manuscript’s intellectual content, and approved the final version. F.V., A.P., S.S.J., I.F., and R.A. curated data and figures, edited the manuscript, and approved its final version. G.S. was responsible for conceptualization, methodology, project administration, and editing the manuscript. P.M. is the guarantor of this work and, as such, had full access to all the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were presented in abstract form at the Scientific Sessions of the American Heart Association 2022, Chicago, IL, 5–7 November 2022.
Publisher Copyright:
© 2023 by the American Diabetes Association.
PY - 2023/2
Y1 - 2023/2
N2 - OBJECTIVE Ischemia with nonobstructive coronary arteries (INOCA) is a prevailing finding in patients with angina. However, the main factors underlying the risk of being re-hospitalized for chest pain in patients with INOCA remain mostly unknown. RESEARCH DESIGN AND METHODS We evaluated INOCA patients referred to the “Casa di Cura Montevergine” in Mercogliano (Avellino), Italy, from January 2016 to January 2021 for percutaneous coronary intervention (PCI). In these subjects, we assessed the impact of the stress hyperglycemia ratio (SHR), defined as the ratio of mmol/L blood glucose and % HbA1c, on the risk of rehospitalization for chest pain. RESULTS A total of 2,874 patients with INOCA successfully completed the study. At the 1-year follow-up, the risk of rehospitalization for chest pain was significantly higher (P < 0.001) in INOCA patients with SHR >1 compared to patients with SHR £1. These findings were confirmed by multivariable analyses (adjusting for poten-tial confounders, including age, BMI, blood pressure, heart rate, chronic kidney disease, and cholesterol), propensity score matching, and inverse probability of treatment weighting. CONCLUSIONS Our data indicate, to our knowledge for the first time, that SHR on hospital admission significantly and independently increases the risk of rehospitalization for chest pain in INOCA patients.
AB - OBJECTIVE Ischemia with nonobstructive coronary arteries (INOCA) is a prevailing finding in patients with angina. However, the main factors underlying the risk of being re-hospitalized for chest pain in patients with INOCA remain mostly unknown. RESEARCH DESIGN AND METHODS We evaluated INOCA patients referred to the “Casa di Cura Montevergine” in Mercogliano (Avellino), Italy, from January 2016 to January 2021 for percutaneous coronary intervention (PCI). In these subjects, we assessed the impact of the stress hyperglycemia ratio (SHR), defined as the ratio of mmol/L blood glucose and % HbA1c, on the risk of rehospitalization for chest pain. RESULTS A total of 2,874 patients with INOCA successfully completed the study. At the 1-year follow-up, the risk of rehospitalization for chest pain was significantly higher (P < 0.001) in INOCA patients with SHR >1 compared to patients with SHR £1. These findings were confirmed by multivariable analyses (adjusting for poten-tial confounders, including age, BMI, blood pressure, heart rate, chronic kidney disease, and cholesterol), propensity score matching, and inverse probability of treatment weighting. CONCLUSIONS Our data indicate, to our knowledge for the first time, that SHR on hospital admission significantly and independently increases the risk of rehospitalization for chest pain in INOCA patients.
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U2 - 10.2337/dc22-0783
DO - 10.2337/dc22-0783
M3 - Article
C2 - 36478189
AN - SCOPUS:85145736353
SN - 1935-5548
VL - 46
SP - 450
EP - 454
JO - Diabetes Care
JF - Diabetes Care
IS - 2
ER -
