Diabetes research and clinical practice · 2026
Hemoglobin glycation index and cardiovascular outcomes in patients with coronary intermediate lesions: insights from a large cohort study.
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Zeng Fanzhou, Song Chenxi, Wang Chunyue, Li Bowen, Wang Hao, Dou Kefei
Аннотация
AIMS: Hemodynamically non-significant intermediate coronary lesions, though generally deferred from revascularization, still carry residual cardiovascular risk. Hemoglobin glycation index (HGI) is a novel indicator reflecting glycemic variability. This study aims to assess the association between HGI and long-term outcomes in these patients.
METHODS: We enrolled 5932 patients with intermediate lesions during 2017 and stratified them into three HGI tertiles. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs) over a median 4.91 - year follow-up .
RESULTS: During follow-up, 192 (3.2%) MACCEs occurred. A J-shaped association between HGI and 5-year MACCEs after adjustment was confirmed (P for non-linearity = 0.007), with an optimal inflection point of -0.24. Above this threshold, each 1-unit HGI increment significantly elevated MACCEs risk (HR 1.138, 95%CI 1.073-1.207, P < 0.001). The High-HGI group had a 76% higher MACCEs risk versus the Medium-HGI reference (HR 1.761, 95%CI 1.233-2.515, P = 0.002), whereas the Low-HGI group showed a non-significant trend toward higher risk.
CONCLUSIONS: HGI has a J-shaped association with MACCEs in patients with intermediate lesions. While a high HGI is a robust independent predictor of adverse events, a low HGI represents a non-significant trend. HGI may serve as a readily accessible biomarker for risk stratification.
METHODS: We enrolled 5932 patients with intermediate lesions during 2017 and stratified them into three HGI tertiles. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs) over a median 4.91 - year follow-up .
RESULTS: During follow-up, 192 (3.2%) MACCEs occurred. A J-shaped association between HGI and 5-year MACCEs after adjustment was confirmed (P for non-linearity = 0.007), with an optimal inflection point of -0.24. Above this threshold, each 1-unit HGI increment significantly elevated MACCEs risk (HR 1.138, 95%CI 1.073-1.207, P < 0.001). The High-HGI group had a 76% higher MACCEs risk versus the Medium-HGI reference (HR 1.761, 95%CI 1.233-2.515, P = 0.002), whereas the Low-HGI group showed a non-significant trend toward higher risk.
CONCLUSIONS: HGI has a J-shaped association with MACCEs in patients with intermediate lesions. While a high HGI is a robust independent predictor of adverse events, a low HGI represents a non-significant trend. HGI may serve as a readily accessible biomarker for risk stratification.