文献类型：期刊文献

英文题名：Association between glycemic variability and mortality after coronary stent implantation in critically ill patients: a retrospective cohort study

作者：Xiang, Xiao-Jun[1,2,3];Sun, Xiao-Long[5];Ma, Dong-Yu[5];Ma, Li[1,4];Liu, Meng-Yang[5];Li, Jian-Feng[2];Zhang, Wen-Bo[1];Wang, Yin-Di[4];Xie, Ping[1,2,5]

第一作者：Xiang, Xiao-Jun

通信作者：Xie, P[1];Xie, P[2];Wang, YD[3];Xie, P[4]

机构：[1]Gansu Univ Chinese Med, Sch Tradit Chinese & Western Med, Lanzhou 730000, Peoples R China;[2]Gansu Prov Hosp, Natl Clin Res Ctr Cardiovasc Dis, Dept Cardiovasc Med, Branch Construction Unit, Lanzhou 730000, Peoples R China;[3]Fengjie Hosp, Chongqing Three Gorges Med Coll, Dept Resp & Crit Care Med, Fengjie 404600, Chongqing, Peoples R China;[4]Gansu Matern & Child Hlth Care Hosp, Gansu Cent Hosp, Dept Geriatr, Lanzhou 730000, Peoples R China;[5]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou 730000, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Sch Tradit Chinese & Western Med, Lanzhou 730000, Peoples R China;[2]corresponding author), Gansu Prov Hosp, Natl Clin Res Ctr Cardiovasc Dis, Dept Cardiovasc Med, Branch Construction Unit, Lanzhou 730000, Peoples R China;[3]corresponding author), Gansu Matern & Child Hlth Care Hosp, Gansu Cent Hosp, Dept Geriatr, Lanzhou 730000, Peoples R China;[4]corresponding author), Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou 730000, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：26

期号：1

外文期刊名：BMC CARDIOVASCULAR DISORDERS

收录：;Scopus(收录号：2-s2.0-105045172155);WOS:【SCI-EXPANDED(收录号:WOS:001822590200001)】；

基金：This work was supported by the National Natural Science Foundation of China (Grant No. 82460051); the Major Project of the Joint Research Fund of Gansu Province (Grant No. 24JRRA886); the "Innovation Star" Program for Postgraduates of the Gansu Provincial Department of Education (Grant No. 2026CXZX-910); the Lanzhou Science and Technology Program (Grant No. 2025-2-187); and the Gansu Provincial Maternity and Child-Care Hospital (Gansu Provincial Center Hospital) (Grant No. GMCCH2024-3-1).

语种：英文

外文关键词：Glycemic variability; Coronary stent implantation; Coronary care unit; Cardiac intensive care unit; Mortality

摘要：Background Glycemic variability (GV) has been associated with adverse outcomes in critical illness; however, its prognostic relevance in patients undergoing coronary stent implantation remains unclear. Methods In this retrospective cohort study, we analyzed 2,427 adult patients who underwent coronary stent implantation and were admitted to the coronary care unit (CCU) or cardiovascular intensive care unit (CVICU) using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Glycemic variability (GV) was defined as the coefficient of variation of blood glucose (standard deviation/mean & times;100%). The primary and secondary outcomes were in-hospital and 365-day all-cause mortality. Associations were assessed using multivariable Cox models. Nonlinear relationships, survival differences, discriminative ability, and mediation effects were evaluated using restricted cubic splines, Kaplan-Meier analysis, time-dependent receiver operating characteristic (ROC) curves, and mediation analysis, respectively. External validation was performed in the eICU Collaborative Research Database. Results Patients in the highest GV quartile had significantly higher risks of in-hospital mortality (HR 2.58, 95% CI 1.30, 5.13) and 365-day mortality (HR 1.77, 95% CI 1.20, 2.60) compared with those in the lowest quartile. A significant trend across GV quartiles was observed (p for trend < 0.01), although excess risk was primarily driven by the highest quartile. These associations were consistent across analyses and were externally validated. Mediation analysis indicated that blood urea nitrogen accounted for 7.7% and 10.3% of the association, respectively. Conclusions Elevated glycemic variability (GV) was independently associated with increased risks of in-hospital and 365-day all-cause mortality after coronary stent implantation. GV may serve as a simple and clinically accessible marker for risk stratification in this population.