{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T03:19:45Z","timestamp":1768533585605,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"crossref","award":["18411950300"],"award-info":[{"award-number":["18411950300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"crossref","award":["19411963200"],"award-info":[{"award-number":["19411963200"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai Science and Technology Committee","doi-asserted-by":"crossref","award":["19XD1403300"],"award-info":[{"award-number":["19XD1403300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81670403"],"award-info":[{"award-number":["81670403"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,24]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim in this study was to stratify maximum blood glucose levels to identify the the best cut-off value of glucose levels to predict mortality in acute coronary syndrome (ACS) patients, regardless of whether they had diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All clinical data were obtained from the \u2018Medical Information Mart for Intensive Care III\u2019 database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      A total of 3078 patients with ACS were included in the study. We divided the patients into four levels based on their maximum blood glucose levels (glucose\n                      <jats:sub>max<\/jats:sub>\n                      ), then analysed the relationship between each group with mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among enrolled patients, 2780 and 298 were survivors and non-survivors, respectively. Blood glucose levels and mortality showed a \u2018tick\u2019 type relationship, with levels 3 and 4 found to be closely associated with increased hospital mortality (p&lt;0.05), relative to level 1 (&lt;6.1\u2009mmol\/L), used as the reference group. No significant association was observed in mortality between level 2 and level 1 (p=0.095). In addition, we found a gradual increase in OR for level 2 (OR: 2.42, 95%\u2009CI 0.86 to 6.80, p=0.095), level 3 (OR: 4.33, 95%\u2009CI 1.55 to 12.13, p=0.005) and level 4 (OR: 7.27, 95%\u2009CI 2.56 to 20.62, p&lt;0.001), relative to level 1. Based on receiver operating characteristic curves, the optimal cut-off value for predicting mortality were 11.5 (area under curve (AUC)=0.724), 11.2 (AUC=0.729), 13.4 (AUC=0.638), 15.8 (AUC=0.717) and 11.3\u2009mmol\/L (AUC=0.764) in all ACS, acute myocardial infarction, unstable angina, diabetes and non-diabetes patients, respectively. The results of subgroup analysis suggested that in patients with significantly elevated blood glucose, the mortality of non-diabetes was higher than patients with diabetes (OR: 0.42, 95%\u2009CI 0.31 to 0.57, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Overall, glucose\n                      <jats:sub>max<\/jats:sub>\n                      \u226511.5\u2009mmol\/L had a significant association with increased mortality in patients with ACS. Non-diabetes ACS patients need a more robust blood glucose management strategy compared with diabetes counterparts.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-042316","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T02:46:36Z","timestamp":1607827596000},"page":"e042316","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Maximum blood glucose levels during hospitalisation to predict mortality in patients with acute coronary syndrome: a retrospective cohort study"],"prefix":"10.1136","volume":"10","author":[{"given":"Jun","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Luwan Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3410-7204","authenticated-orcid":false,"given":"Xuebo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,12]]},"reference":[{"key":"2025121222274224000_10.12.e042316.1","unstructured":"Singh A , Museedi AS , Grossman SA . 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