Stress Hyperglycemia Drives the Risk of Hospitalization for Chest Pain in Patients With Ischemia and Nonobstructive Coronary Arteries (INOCA)

• Published in: Diabetes care Vol. 46; no. 2; pp. 450 - 454
• Main Authors: Mone, Pasquale, Lombardi, Angela, Salemme, Luigi, Cioppa, Angelo, Popusoi, Grigore, Varzideh, Fahimeh, Pansini, Antonella, Jankauskas, Stanislovas S., Forzano, Imma, Avvisato, Roberta, Wang, Xujun, Tesorio, Tullio, Santulli, Gaetano
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.02.2023
• Subjects: Angina; Arteries; Blood pressure; Cardiovascular and Metabolic Risk; Chest; Chest Pain - etiology; Cholesterol; Coronary artery; Coronary Artery Disease - complications; Coronary Vessels; Health risks; Heart diseases; Heart rate; Hospitalization; Humans; Hyperglycemia; Ischemia; Kidney diseases; Pain; Patients; Percutaneous Coronary Intervention; Risk
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc22-0783

Ischemia with nonobstructive coronary arteries (INOCA) is a prevailing finding in patients with angina. However, the main factors underlying the risk of being rehospitalized for chest pain in patients with INOCA remain mostly unknown. We evaluated INOCA patients referred to the "Casa di Cura Montevergine" in Mercogliano (Avellino), Italy, from January 2016 to January 2021 for percutaneous coronary intervention (PCI). In these subjects, we assessed the impact of the stress hyperglycemia ratio (SHR), defined as the ratio of mmol/L blood glucose and % HbA1c, on the risk of rehospitalization for chest pain. A total of 2,874 patients with INOCA successfully completed the study. At the 1-year follow-up, the risk of rehospitalization for chest pain was significantly higher (P < 0.001) in INOCA patients with SHR >1 compared to patients with SHR ≤1. These findings were confirmed by multivariable analyses (adjusting for potential confounders, including age, BMI, blood pressure, heart rate, chronic kidney disease, and cholesterol), propensity score matching, and inverse probability of treatment weighting. Our data indicate, to our knowledge for the first time, that SHR on hospital admission significantly and independently increases the risk of rehospitalization for chest pain in INOCA patients.