Glucose-to-potassium ratio independently predicts long-term adverse outcomes in patients with coronary artery disease after PCI

Abstract

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. This study aimed to investigate the association between GPR and long-term adverse outcomes in patients with CAD after percutaneous coronary intervention (PCI). 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. 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). 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.