The role of leuko‐glycemic index in predicting 30‐day mortality in diabetic and non‐diabetic patients with acute coronary syndrome

Abstract Background The leuko‐glycemic index (LGI) has been suggested as a possible prognostic marker for Acute coronary syndrome (ACS) but, its predictive capacity for mortality, especially among individuals with diabetes, remains poorly understood. Objective In this study, we aimed to evaluate the predictive capability of LGI concerning 30‐day in‐hospital mortality among emergency room patients, who were diagnosed with ACS and subsequently treated in the coronary intensive care unit (CICU). Methods From 1 January 2022 to 1 January 2023, consecutive patients with ACS admitted to the CICU of a tertiary Emergency Department (ED) were enrolled. The cohort was stratified by diabetes status, and the prognostic performance of the admission LGI for 30‐day in‐hospital mortality was evaluated. Results We enrolled 397 patients in the present investigation. Especially, deceased diabetic patients presented with significantly higher LGI values ( p < 0.001). LGI showed that the area under the curve for predicting mortality was 0.674 in diabetic patients and 0.679 in non‐diabetic patients. For diabetic patients, an LGI ≥ 2757.6 mg/dl.mm 3 yielded a sensitivity of 61%, specificity of 77%, negative predictive value (NPV) of 90%, and positive predictive value (PPV) of 36%. In non‐diabetic patients, an LGI value of ≥ 1783.4 mg/dl.mm 3 yielded 47% sensitivity, 91% specificity, 95% NPV, and 31% PPV. Higher LGI independently predicted in‐hospital mortality in diabetic patients (OR = 1.000, 95% CI [1.000–1.001], p = 0.009). Conclusions Our results suggests that higher LGI values are independent predictors of 30‐day mortality in diabetic patients. The inclusion of LGI in existing risk assessment methodologies within the ED setting has the potential to refine prognostic precision and guide therapeutic decision‐making for individuals presenting with chest pain.