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A retrospective cohort of 600 consecutive STEMI patients stratified by glycemic control evaluates whether glucose and HbA1c, plus SHR and glycemic gap, independently predict early LVEF improvement and whether patterns persist at 30–90 days alongside early MACE.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/from-metabolism-to-myocardium-the-missing-link-of-admission-dysglycemia-in-early-cardiac-recovery/452557/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/from-metabolism-to-myocardium-the-missing-link-of-admission-dysglycemia-in-early-cardiac-recovery/452557.png","ImageObject",300,407,{"name":92,"@type":93},"nayy☆","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the study’s main objective?","Question",{"text":113,"@type":114},"To determine whether admission glycemia (glucose and HbA1c) and relative stress-adjusted indices (SHR and glycemic gap) are independently associated with early improvement in left ventricular ejection fraction after PPCI, and whether associations persist through 30–90 days alongside early MACE.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the research conducted?",{"text":118,"@type":114},"A retrospective cohort of 600 consecutive STEMI patients undergoing PPCI (January 2023–December 2024) was stratified a priori into good, intermediate, or poor glycemic control. Outcomes were modeled using ANCOVA with sensitivity analyses including mixed-effects models and alternative index specifications.",{"name":120,"@type":111,"acceptedAnswer":121},"What did the results show about early recovery?",{"text":122,"@type":114},"Early LVEF gains were greater in good glycemic control than in intermediate or poor control. Adjusted analyses showed lower follow-up LVEF with worsening admission glycemia, with stepwise gradients persisting at 30 and 90 days and aligning with higher MACE across strata.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},452557,1790764130,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},962090893153,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Khan et al. Cardiovascular Diabetology – Endocrinology Reports (2026) 12:1  \n[https://doi.org/10.1186/s40842-025-00265-1](https://doi.org/10.1186/s40842-025-00265-1)  \nCardiovascular Diabetology – Endocrinology Reports  \nRESEARCH Open Access  \nFrom metabolism to myocardium: the missing  link of admission dysglycemia in early cardiac recovery  \nFahad Raja Khan 1, Fazal Akbar 1* and Kamran Aslam 1*  \nAbstract  \nBackground Admission dysglycemia is linked to adverse outcomes after ST-elevation myocardial infarction (STEMI); however, its relationship with early recovery of left ventricular (LV) function after primary percutaneous coronary intervention (PPCI), particularly when using stress-adjusted indices, remains uncertain in South Asian settings. Objective To evaluate whether admission glycemia (glucose and hemoglobin A1c [HbA1c]) and relative indices (stress hyperglycemia ratio [SHR] and glycemic gap) are independently associated with early improvement in LV ejection fraction (LVEF) and whether these associations persist at 30–90 days and align with early major adverse cardiovascular events (MACE) .  \nMethods A retrospective cohort of 600 consecutive STEMI patients undergoing PPCI (January 2023–December 2024) was stratified a priori into good, intermediate, or poor glycemic control. The primary outcome was follow-up LVEF within 7 days, modeled by analysis of covariance (ANCOVA) with baseline LVEF and clinical/angiographic covariates (heteroscedasticity-robust HC3 standard error) . Sensitivity analyses included two-time-point mixed-effects models, continuous SHR/glycemic gap specifications (with splines), a non-diabetic subset, and adjustment for echocardiography timing.  \nResults Early LVEF gains were greater with good control than with intermediate or poor control (mean change, 4. 13%[SD, 4 . 78] vs. 2. 15%(SD, 5 . 12) and 1. 01%[5 .45]; p \u003C 0. 001) . In adjusted analyses, follow-up LVEF was lower in intermediate vs good by −2 .42% points (95% CI, −3.38 to −1 .46) and in poor vs good by −3 . 74% points (95% CI, −4.76 to −2 . 71) (both p \u003C 0. 001) . Accordingly, early recovery declined stepwise with worsening admission glycemia, and the gradient persisted at 30 and 90 days in parallel with higher MACE across the strata. Accordingly, early recovery declined stepwise with worsening admission glycemia, and the gradient persisted at 30 and 90 days in parallel with higher MACE across the strata.  \nConclusions Admission dysglycemia, including stress-adjusted indices, was associated with attenuated early LVEF recovery after PPCI, with signals persisting through 90 days and aligning with early MACE. In practice, routine HbA1canchored stress-adjusted profiling at presentation may refine risk stratification and support protocol ized inpatient glucose management.  \n*Correspondence: Fazal Akbar [Fazal_46@yahoo.com](Fazal_46@yahoo.com)[ ](Fazal_46@yahoo.com)Kamran Aslam  \n[Kamran.aslam.wazir@outlook.com](Kamran.aslam.wazir@outlook.com)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright h","cbCaim45Nqa1kUfG","https://ap.wps.com/l/cbCaim45Nqa1kUfG","pdf",2107651,11,"English","# Abstract\n## Background and Objective\n## Methods\n## Results\n## Conclusions\n# Significance\n## What is known\n## Key research question\n## What is new\n## Clinical practice impact\n# Introduction","[{\"question\":\"What is the study’s main objective?\",\"answer\":\"To determine whether admission glycemia (glucose and HbA1c) and relative stress-adjusted indices (SHR and glycemic gap) are independently associated with early improvement in left ventricular ejection fraction after PPCI, and whether associations persist through 30–90 days alongside early MACE.\"},{\"question\":\"How was the research conducted?\",\"answer\":\"A retrospective cohort of 600 consecutive STEMI patients undergoing PPCI (January 2023–December 2024) was stratified a priori into good, intermediate, or poor glycemic control. Outcomes were modeled using ANCOVA with sensitivity analyses including mixed-effects models and alternative index specifications.\"},{\"question\":\"What did the results show about early recovery?\",\"answer\":\"Early LVEF gains were greater in good glycemic control than in intermediate or poor control. Adjusted analyses showed lower follow-up LVEF with worsening admission glycemia, with stepwise gradients persisting at 30 and 90 days and aligning with higher MACE across strata.\"}]","From Metabolism to Myocardium - The Missing Link of Admission Dysglycemia in Early Cardiac Recovery | PDF",1790737383,28]