Key result
Elevated glucose-to-potassium ratio is linked to ~12% higher 5-year MACCE risk after PCI.
Why the study?
Although the glucose-to-potassium ratio (GPR) has shown prognostic value in intracerebral hemorrhage and heart failure, its prognostic significance for long-term adverse outcomes in patients with CAD undergoing PCI remained undetermined.
Does an elevated glucose-to-potassium ratio predict long-term major adverse cardiac and cerebrovascular events and all-cause mortality in patients with coronary artery disease undergoing percutaneous coronary intervention?
Cohort (n=9,585)
Does an elevated glucose-to-potassium ratio predict long-term major adverse cardiac and cerebrovascular events and all-cause mortality in patients with coronary artery disease undergoing percutaneous coronary intervention?
The glucose-to-potassium ratio independently predicts 5-year MACCE and all-cause mortality in CAD patients undergoing PCI, offering a simple biomarker for residual risk stratification.
Background The glucose-to-potassium ratio (GPR) is an emerging metabolic biomarker that has demonstrated prognostic value in several acute conditions, including intracerebral hemorrhage and heart failure. However, its prognostic significance in patients with coronary artery disease (CAD) remains undetermined. Purpose This study aimed to investigate the association between GPR and long-term adverse outcomes in patients with CAD after percutaneous coronary intervention (PCI). Methods A total of 10,724 consecutive CAD patients undergoing PCI in 2013 were screened, and 9,585 with complete data were included in the final analysis. The primary endpoint was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), and the secondary endpoint was all-cause mortality during the 5-year follow-up. GPR was analyzed as a continuous variable. Results Among the 9,585 patients, mean age was 58.4±10.3 years and 77.2% were male. Restricted cubic spline analyses indicated a linear association between GPR and both endpoints, with all tests reaching statistical significance (P < 0.05) and no evidence of nonlinearity (P for nonlinearity > 0.05). Cox proportional hazards models showed that elevated GPR was significantly associated with increased risks of MACCE and all-cause mortality across all adjustment models. In the fully adjusted model (Model 3), GPR remained an independent predictor of MACCE (hazard ratio [HR]: 1.123; 95% confidence interval [CI]: 1.029–1.225) and all-cause death (HR: 1.355; 95% CI: 1.125–1.631). Conclusion GPR is an independent predictor of long-term adverse outcomes after PCI and may serve as a simple, accessible marker for residual risk stratification in routine clinical practice.
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Zhang et al. (2026) conducted a cohort in Coronary artery disease after percutaneous coronary intervention (PCI) (n=9,585). Elevated glucose-to-potassium ratio (GPR) vs. Continuous variable (per unit increase in GPR) was evaluated on Major adverse cardiac and cerebrovascular events (MACCE) (HR 1.123, 95% CI 1.029-1.225, p=<0.05). Elevated glucose-to-potassium ratio independently predicted 5-year major adverse cardiac and cerebrovascular events after PCI (HR 1.123; 95% CI 1.029-1.225).
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