Hemoglobin glycation index and cardiovascular outcomes in patients with coronary intermediate lesions: insights from a large cohort study.

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.