Key result
High leuko-glycemic index is linked to ~5.8-fold higher post-MI mortality, but clinical utility remains limited.
Why the study?
Evidence on the prognostic value of the leuko-glycemic index in acute MI lacks consensus, and various reported cut-offs have raised concern regarding clinical applicability.
Does the leuko-glycemic index predict mortality and major cardiac complications in patients with acute myocardial infarction?
Meta-Analysis (n=3,701)
Does the leuko-glycemic index predict mortality and major cardiac complications in patients with acute myocardial infarction?
Answers are grounded in this paper and cite their sources.
While the leuko-glycemic index shows moderate predictive ability for mortality and complications post-MI, its low post-test probability limits its clinical applicability for risk stratification.
Introduction: In recent years, studies have provided evidence on the prognostic value of the leuko-glycemic index (LGI) in acute myocardial infarction (MI), but there is a lack of consensus. In addition, various reported cut-offs for LGI have raised concern regarding its clinical applicability. So, to conclude, through this systematic review and meta-analysis, we aimed to investigate all available evidence on the prognostic value of LGI in acute MI. Methods: Two independent researchers summarized records available in the four main databases of Medline (Via PubMed), Embase, Scopus, and Web of Science until 15 Sep 2022. Articles studying the prognostic value of the LGI in acute MI were included. Finally, sensitivity, specificity, prognostic odds ratio, and the area under the curve (AUC) for LGI were analyzed and reported. Results: Eleven articles were included (3701 patients, 72.1% male). Based on the analyses, AUC, sensitivity, and specificity for LGI in prediction of mortality following acute MI were 0.77 (95% CI: 0.73 to 0.80), 0.75 (95% CI: 0.62 to 0.84), and 0.66 (95% CI: 0.51 to 0.78), respectively. Positive and negative post-test probability of LGI in prediction of mortality were 21% and 5%, respectively. AUC, sensitivity, and specificity for LGI in prediction of major cardiac complications after acute MI were 0.81 (95% CI: 0.77 to 0.84), 0.84 (95% CI: 0.70 to 0.92), and 0.64 (95% CI: 0.49 to 0.84), respectively. Also, the Positive and negative post-test probability of LGI in this regard were 59% and 13%, respectively. Conclusion: Although the results demonstrated that the LGI could predict mortality and acute cardiac complication after MI, the low post-test probability of LGI in risk stratification of patients raises questions regarding its applicability. Nevertheless, as most of the available studies have been conducted in the Latino/Hispanic population, further evidence is warranted to generalize the validity of this tool to other racial populations.
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Sadeghi et al. (2023) conducted a meta-analysis in Acute myocardial infarction (n=3,701). Leuko-glycemic index vs. Non-outcome group was evaluated on Mortality following acute myocardial infarction (OR 5.76, 95% CI 3.60 to 9.22). The leuko-glycemic index demonstrated value in predicting mortality following acute myocardial infarction with a prognostic odds ratio of 5.76, although its low post-test probability limits clinical applicability.
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