Endocrine · 2025
Association between admission serum calcium levels and in‑hospital mortality in acute myocardial infarction patients with cardiovascular-kidney-metabolic syndrome.
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Xu Jing, Yu Shuai, Huang Jian, Geng Li, Wei Yumiao, Li Xin, Gong Xin
Аннотация
PURPOSE: Acute myocardial infarction (AMI) with cardiovascular-kidney-metabolic (CKM) condition is linked to a high in-hospital mortality. Some previous studies reported that calcium may be related with in-hospital mortality among patients with AMI. However, there is no report about the association between serum calcium and AMI patients with CKM syndrome. Therefore, this study investigated the association between admission serum calcium levels and in-hospital mortality in a cohort of AMI patients with CKM syndrome.
METHODS: This retrospective cohort study enrolled 2537 admitted patients with AMI including 270 patients with CKM. All the data were extracted from electronic medical records from May 2019 to April 2024. According to the reference range of serum calcium, all the 270 patients were divided into two groups, low calcium group (0-2.10 mmol/L) and non-low calcium group (from 2.11 mmol/L). The primary endpoint was in-hospital mortality.
RESULTS: The in-hospital mortality rate was significantly higher in the low calcium cohort (16.8%, n = 19) compared to the non-low calcium group (8.3%, n = 13). After adjusting for age, gender, hypertension, atrial fibrillation, stroke and smoke, patients in the low calcium group demonstrated significantly higher in-hospital mortality compared to the non-low calcium group (OR = 2.409, 95% CI: 1.105-5.249, p < 0.05). In subgroup analyses, the multivariable logistic regression models indicated that serum calcium was an independent predictor for in-hospital mortality in females (OR = 7.453; 95% CI = 1.751-31.730; p < 0.05) and elderly patients (OR = 3.122; 95% CI = 1.167-8.348; p < 0.05) after adjustments for hypertension, atrial fibrillation, stroke and smoke. Restricted cubic splines (RCS) regression analysis showed a dose-response relationship between serum calcium and in-hospital mortality (nonlinear P value = 0.067).
CONCLUSIONS: Admission hypocalcemia is an independent risk factor of in-hospital mortality in AMI patients with CKM syndrome, especially in elderly individuals (aged ≥76 years) and females.
METHODS: This retrospective cohort study enrolled 2537 admitted patients with AMI including 270 patients with CKM. All the data were extracted from electronic medical records from May 2019 to April 2024. According to the reference range of serum calcium, all the 270 patients were divided into two groups, low calcium group (0-2.10 mmol/L) and non-low calcium group (from 2.11 mmol/L). The primary endpoint was in-hospital mortality.
RESULTS: The in-hospital mortality rate was significantly higher in the low calcium cohort (16.8%, n = 19) compared to the non-low calcium group (8.3%, n = 13). After adjusting for age, gender, hypertension, atrial fibrillation, stroke and smoke, patients in the low calcium group demonstrated significantly higher in-hospital mortality compared to the non-low calcium group (OR = 2.409, 95% CI: 1.105-5.249, p < 0.05). In subgroup analyses, the multivariable logistic regression models indicated that serum calcium was an independent predictor for in-hospital mortality in females (OR = 7.453; 95% CI = 1.751-31.730; p < 0.05) and elderly patients (OR = 3.122; 95% CI = 1.167-8.348; p < 0.05) after adjustments for hypertension, atrial fibrillation, stroke and smoke. Restricted cubic splines (RCS) regression analysis showed a dose-response relationship between serum calcium and in-hospital mortality (nonlinear P value = 0.067).
CONCLUSIONS: Admission hypocalcemia is an independent risk factor of in-hospital mortality in AMI patients with CKM syndrome, especially in elderly individuals (aged ≥76 years) and females.