Association Between Glycemic Variability Indices and Clinical Outcomes in Patients Without Diabetes Presenting with ST-Segment Elevation Myocardial Infarction: A Prospective Cohort Study

Abstract

Introduction. Glycemic variability (GV) has emerged as a potential prognostic marker in acute cardiovascular conditions. While its association with adverse outcomes has been widely studied in diabetic populations, limited data exist regarding its clinical impact in non-diabetic patients presenting with ST-segment elevation myocardial infarction (STEMI). Aim. This study aimed to evaluate the association between glycemic variability indices and short-term clinical outcomes in non-diabetic patients with STEMI. Materials and Methods. This prospective cohort study included 133 non-diabetic patients with STEMI admitted to a tertiary cardiac center. Blood glucose levels were measured serially during the first five days of hospitalization. Glycemic variability was assessed using the coefficient of variation (CoV), with a median cut-off value of 13.2 % used to categorize patients into low and high GV groups. Clinical outcomes, including mortality, heart failure, recurrent angina, and stroke, were assessed during hospitalization and up to 30 days to three months after discharge. Statistical analysis was performed using bivariate tests, with p<0.05 considered statistically significant. Results. The median age of participants was 60 years, and 78.2 % were male. Mortality occurred in 13.5 % of patients, heart failure in 74.4 %, recurrent angina in 30.1 %, and stroke in 8.3 %. No statistically significant associations were found between high GV (CoV≥13.2 %) and mortality (p=0.327), heart failure (p=0.959), recurrent angina (p=0.955), or stroke (p=0.110). Conclusions. In non-diabetic patients with STEMI, glycemic variability assessed during the acute hospitalization period was not significantly associated with short-term adverse clinical outcomes. These findings suggest that moderate glucose fluctuations in this population may not independently predict early complications.

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