Evidence mapPaperPMID 40940664Full record

ArticleLipids in health and disease2025

Integrated metabolic-inflammatory risk assessment: HbA1c/HDL-c and hsCRP-to-albumin ratios synergistically predict major adverse cardiovascular events in post-PCI STEMI patients.

Jinyong Huang, Junyi Zhang, Zhonghui Xie, Linjie Li, Meiyan Chen, Yongle Li, Xiangdong Yu, Shaozhuang Dong, Qing Wang, Jun Chen and 2 more

Abstract read
In one paragraph

Article in Lipids in health and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Apoptotic markers and Dectin-1BMC cardiovascular disorders · 2026
    Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jinyong Huang *Department of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Junyi Zhang *Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Zhonghui XieDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Linjie LiDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Meiyan ChenDepartment of Emergency, Qilu Hospital of Shandong University, Shandong, China.
Yongle LiDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Xiangdong YuDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Shaozhuang DongDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Qing WangDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Jun ChenDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Qing YangDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China. cardio-yq@outlook.com.
Shaopeng XuDepartment of Cardiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China. tjzyyxsp@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study looked into how predictive in ST-segment elevation myocardial infarction (STEMI) is the high-sensitivity C-reactive protein-to-albumin ratio (hsCAR) as well as glycated hemoglobin to high-density lipoprotein cholesterol (HbA1c/HDL-c) ratio.

methodsThis retrospective cohort research was carried out on 1,177 patients having STEMI who were given percutaneous coronary intervention (PCI). For major adverse cardiovascular events (MACE), the independent and combined predictive values of the HbA1c/HDL-c ratio (threshold ≥ 6.61) and hsCAR (threshold ≥ 0.18) were assessed. MACE was an amalgamation of death from all causes, ischemia-induced revascularization, myocardial infarction not leading to death, heart failure hospitalization, and cerebrovascular events. The team used Cox regression models, causal mediation examination, and receiver operating characteristic curves to assess prognostic performance and mechanistic pathways, and compared them with the Global Registry of Acute Coronary Events (GRACE) risk score.

resultsThe interquartile range for follow-up was 79 to 672 days, with 461 median days. A raised HbA1c/HDL-c ratio (≥ 6.61) and hsCAR (≥ 0.18) independently predicted MACE, with 1.51 (95% confidence interval [CI]: 1.26-1.81; P < 0.001) as well as 1.84 (95% CI: 1.53-2.21; P = 0.005) hazard ratios (HRs), respectively. Combined use enhanced risk stratification, with the high HbA1c/HDL-c-high hsCAR group showing the highest risk (adjusted HR 2.19, 95% CI: 1.67-2.87; P < 0.001). Causal mediation examination revealed that coronary lesion complexity partially mediated these associations; the SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) and the residual SYNTAX scores were responsible for accounting for 24.2%/17.7% of the hsCAR effect and 16.8%/25.2% of the HbA1c/HDL-c ratio effect, respectively. Compared with the individual markers or the GRACE risk score, the combined biomarker model demonstrated superior discriminatory capacity (area under the curve = 0.63, 95% CI = 0.60-0.66; P < 0.001), with significant improvement in integrated discrimination.

conclusionThe integration of HbA1c/HDL-c and hsCAR can significantly improve risk stratification in patients with STEMI, outperforming traditional scoring systems and assisting in the precise management of individuals at risk.

Indexed as

Cholesterol, HDLC-Reactive ProteinGlycated HemoglobinPercutaneous Coronary InterventionSerum AlbuminST Elevation Myocardial InfarctionAgedBiomarkersFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesRisk AssessmentRisk FactorsBiomarkersCholesterol, HDLC-Reactive ProteinGlycated Hemoglobinhemoglobin A1c protein, humanSerum AlbuminHbA1c/HDL-c ratioHigh-sensitivity c-reactive protein-to-albumin ratioMajor adverse cardiovascular eventsRisk stratificationST-elevation myocardial infarction

Identifiers

PMID40940664
PMCPMC12433004

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.