BACKGROUND We aim to find out the relationship between random blood glucose (RBG), fasting blood glucose (FBG) and in-hospital adverse events in ST-segment elevation acute myocardial infarction (STEMI) patients. We evaluate and compare the predictive value of RBG and FBG on in-hospital adverse events, and give an appropriate cut-off value of RBG and FBG. METHOD A retrospective study enrolled 958 consecutive AMI patients undergoing emergency coronary angiography at Zhongda Hospital were enrolled from January 1, 2016, to December 31, 2018 was performed. RBG and FBG, baseline data and adverse events were recorded. Major adverse cardiovascular and cerebrovascular events (MACCE) were defined as death, nonfatal recurrent myocardial infarction and stroke. Other adverse events included malignant arrhythmia, cardiac shock and hemorrhage. Patients with RBG > 11.1 mmol/L were divided into elevated RBG group. Patients with FBG > 6.1 mmol/L were divided into elevated FBG group. The incidence of in-hospital adverse events were compared in elevated RBG/FBG group and the control group. ROC curve was used to evaluate the predictive value of RBG and FBG on in-hospital adverse events. RESULT The incidence of death, hemorrhage, cardiac shock and malignant arrhythmia significantly increases in elevated RBG and FBG group. Binary logistic regression showed that age, hypertension, diabetes, FBG and RBG were independent risk factors for in-hospital adverse events in STEMI patients. The AUC and 95% CI of RBG and FBG in predicting death of AMI patients were 0.789, 0.759~0.816; 0.810, 0.783~0.835, respectively. The cut-off values were 13.82 and 7.35 mmol/L. RBG and FBG also had fine predictive value on cardiac shock and malignant arrhythmia, no statistical difference was found in the predictive value on in-hospital adverse events (P = 0.462, P = 0.570, P = 0.694). CONCLUSION Incidence of in-hospital adverse events significantly increases in AMI patients combined with elevated RBG or FBG. Both RBG and FBG were independent risk factors for in-hospital adverse events, they had good value on predicting in-hospital adverse events and there was no statistical difference in their predictive value.

中文翻译：

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ST段抬高急性心肌梗死患者随机血糖与空腹血糖对院内不良事件的预测价值。

背景技术我们旨在找出ST段抬高急性心肌梗死（STEMI）患者中随机血糖（RBG），空腹血糖（FBG）与医院内不良事件之间的关系。我们评估和比较RBG和FBG对医院内不良事件的预测价值，并给出RBG和FBG的适当临界值。方法回顾性研究纳入2016年1月1日至2018年12月31日在中大医院接受急诊冠状动脉造影检查的958例AMI患者。记录RBG和FBG，基线数据和不良事件。主要的不良心血管和脑血管事件（MACCE）被定义为死亡，非致命性复发性心肌梗塞和中风。其他不良事件包括恶性心律失常，心脏休克和出血。RBG> 11.1 mmol / L的患者分为升高的RBG组。FBG> 6.1 mmol / L的患者分为FBG升高组。比较RBG / FBG升高组和对照组的院内不良事件发生率。ROC曲线用于评估RBG和FBG对医院内不良事件的预测价值。结果RBG和FBG升高组的死亡，出血，心律失常和恶性心律失常的发生率显着增加。二元逻辑回归分析显示，年龄，高血压，糖尿病，FBG和RBG是STEMI患者院内不良事件的独立危险因素。RBG和FBG预测AMI患者死亡的AUC和95％CI分别为0.789、0.759〜0.816；分别为0.810、0.783〜0.835。临界值为13.82和7.35 mmol / L。RBG和FBG对心律失常和恶性心律失常也具有良好的预测价值，对医院内不良事件的预测值没有统计学差异（P = 0.462，P = 0.570，P = 0.694）。结论AMI患者合并RBG或FBG升高，院内不良事件的发生率显着增加。RBG和FBG均为院内不良事件的独立危险因素，它们在预测院内不良事件方面具有良好的价值，其预测价值无统计学差异。