Prognostic Value of the Leuko-glycemic Index in Acute Myocardial Infarction. Results from the SCAR Multicenter Registry

Background: Leukocytosis and hyperglycemia correlate with worse short-term prognosis in patients with acute coronarysyndrome, but their new relationship, called leuko-glycemic index (LGI), has been scarcely evaluated.Objectives: The aim of this study was to analyze the prognostic value of LGI in patients with ST-segment-elevation acutemyocardial infarction (STEMI) and its added value to classical risk scores.Methods: Patients diagnosed with STEMI from the SCAR (Acute Coronary Syndromes in Argentina) Multicenter Registrywere analyzed. The final endpoint was death or in-hospital Killip-Kimball 3-4 (KK 3-4). The LGI was analyzed as a continuousvariable and in quartiles according to 25, 50 and 75 percentile values.Results: The study evaluated 405 out of 476 patients with final STEMI diagnosis. Presence of the primary endpoint significantlyincreased per LGI quartile: 0%, 7.60%, 9.30% and 30.60% (p < 0.0001). The LGI area under the ROC curve for the compositeendpoint was 0.77 [(95% CI 0.71-0.88); p = 0.0001]; the best prognostic cut-off value was 1000. Presence of death or KK 3-4was 0% and 13% in STEMI patients with LGI below or above 1000, respectively. In a multivariate logistic regression model,LGI was independently associated with death or KK 3-4. The area under the ROC curve of the TIMI risk score for STEMIwas 0.58. The addition of LGI increased its discriminatory capacity to 0.66 (p = 0.001).Conclusions: The LGI was an independent predictor of adverse outcome in STEMI patients (death or KK 3-4), adding prognosticvalue to the TIMI risk score.