Fasting blood glucose to lymphocyte ratio predicting the long-term cardiac mortality in unstable angina pectoris patients

Background: This retrospective study aims to explore the predictive value of the fasting blood glucose to lymphocyte count ratio (GLR) for coronary artery lesion severity and long-term cardiac mortality in patients with unstable angina pectoris (UAP), which has not been previously reported. Methods: 4110 patients with UAP were included in the study. The patients were classified into two groups based on their GLR values and were followed for an average of 36 months. Outcomes, including cardiac mortality, all-cause mortality, and rehospitalization rate, were analyzed, and the predictive value of GLR for long-term cardiac mortality was determined. Results: Among all patients, 865 (21.0%) were re-hospitalized and 103 (2.5%) died, including 39 cardiac deaths (0.9%). The high GLR group had a greater SYNTAX score compared to the low GLR group (p < 0.001). The cardiac mortality (p = 0.006) and rehospitalization (p = 0.004) rates were higher in the high GLR group. Kaplan-Meier curve indicated higher cardiac mortality when GLR was ≥3.38 (p = 0.005). Receiver operating characteristic (ROC) analysis revealed that a GLR of 2.9861 was an effective cutoff value for predicting cardiac mortality (p = 0.001). Multivariate Cox regression analysis showed that serum creatinine (p = 0.003), GLR (p = 0.029), and SYNTAX score (p < 0.001) were independent predictors of cardiac mortality. Conclusions: GLR was significantly correlated with coronary artery lesion severity and can be used as an independent predictor of cardiac mortality in patients with UAP.