ArticleBMC cardiovascular disorders2026
Association between glucose-to-platelet ratio and all-cause mortality in critically ill patients with acute myocardial infarction: a retrospective cohort study.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute myocardial infarction (AMI) in critically ill patients is associated with high mortality. The glucose-to-platelet ratio (GPR), derived from routine early glucose and platelet measurements, may provide additional prognostic information, but its value in ICU patients with AMI remains unclear.
methodsThis retrospective cohort study included 4,676 adult ICU patients with AMI from the MIMIC-IV version 3.1 database. GPR was calculated as the mean glucose concentration during the first 24 h after ICU admission divided by the first platelet count recorded within the same period. Outcomes were 30-day and 360-day all-cause mortality from ICU admission. Associations were assessed using multivariable Cox proportional hazards models, restricted cubic splines, and exploratory internally validated prediction models.
resultsAmong 4,676 patients, the 30-day and 360-day mortality rates were 19.6% and 29.1%, respectively. In the fully adjusted model, each 1-unit increase in GPR was associated with higher 30-day mortality (HR, 1.10; 95% CI, 1.05-1.15) and 360-day mortality (HR, 1.12; 95% CI, 1.07-1.16; both P < 0.001). Compared with the lowest tertile, the highest GPR tertile was associated with increased 30-day mortality (HR, 1.60; 95% CI, 1.35-1.90) and 360-day mortality (HR, 1.29; 95% CI, 1.12-1.47; both P < 0.001). Spline analyses suggested nonlinearity only for 30-day mortality. In exploratory internal validation, ridge regression incorporating GPR achieved an area under the receiver operating characteristic curve of 0.816.
conclusionsHigher GPR was independently associated with increased short- and long-term all-cause mortality in critically ill patients with AMI. GPR may complement conventional variables for early ICU risk stratification.
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