Association between hemoglobin glycation index and all-cause mortality in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.
Jiang H, Zhao Y, et al. • Frontiers in endocrinology • 2026
Higher hemoglobin glycation index (HGI) was associated with more favorable survival in NSTEMI patients undergoing PCI, with a 1-unit increase in HGI associated with a 43% lower risk of all-cause mortality.
Key Findings
Results
Higher HGI was independently associated with lower all-cause mortality risk in NSTEMI patients undergoing PCI.
In the fully adjusted model, a 1-unit increase in HGI was associated with a 43% lower risk of all-cause mortality (HR=0.57, 95% CI: 0.40-0.82, P=0.002)
Patients in the highest HGI tertile had a significantly lower risk of mortality than those in the lowest HGI tertile (HR=0.26, 95% CI: 0.10-0.66, P=0.004)
Analysis was based on 635 patients with NSTEMI who underwent PCI between January 2016 and July 2023 at a single center
Median follow-up duration was 60 months
Kaplan-Meier analysis, Cox regression, restricted cubic spline analysis, and subgroup analyses were all performed
Results
The association between HGI and all-cause mortality followed a linear inverse pattern.
Restricted cubic spline (RCS) analysis indicated a linear inverse association between HGI and all-cause mortality
This linearity suggests no threshold effect; risk reduction was continuous across the range of HGI values
The finding supports HGI as a continuous rather than categorical risk marker in this population
Results
Exploratory subgroup analyses suggested the inverse association between HGI and mortality appeared more evident in men than in women.
Sex-based subgroup analysis was performed as part of exploratory analyses
The authors describe this as an exploratory finding, suggesting it should be interpreted with caution
The differential association by sex may reflect biological differences in hemoglobin glycation or study population characteristics
The study did not report specific HRs for the sex subgroups in the abstract
Methods
The study population consisted of 635 NSTEMI patients who underwent PCI at a single center over approximately seven years.
This was a single-center cohort study
Patients were enrolled between January 2016 and July 2023
The primary endpoint was all-cause mortality
The cohort was followed for a median of 60 months (5 years)
Conclusions
HGI was proposed as a complementary marker for risk stratification in NSTEMI patients undergoing PCI.
The authors state HGI 'may serve as a complementary marker for risk stratification in patients with NSTEMI undergoing PCI'
HGI has emerged as a potential marker for cardiovascular risk stratification more broadly
Prior to this study, the prognostic value of HGI in NSTEMI patients undergoing PCI was described as 'unclear'
The study highlights HGI as distinct from HbA1c alone, as it captures individual variation in hemoglobin glycation
What This Means
This research suggests that a measure called the hemoglobin glycation index (HGI) — which reflects how much a person's blood sugar 'sticks' to their red blood cells relative to what would be expected based on their average blood sugar level — is linked to survival outcomes in heart attack patients. Specifically, the study followed 635 patients who had a type of heart attack called NSTEMI and were treated with a procedure to open blocked arteries (PCI) for an average of five years. It found that patients with higher HGI values were significantly less likely to die during the follow-up period, even after accounting for other health factors. Patients in the top third of HGI values had about 74% lower mortality risk compared to those in the bottom third.
The relationship between HGI and survival was linear — meaning higher HGI was consistently associated with better outcomes across the entire range measured, with no particular cutoff point where the effect suddenly changed. Exploratory analyses also suggested this protective association may be stronger in men than in women, though this finding requires further investigation in larger, more diverse studies.
This research suggests that HGI, which goes beyond standard blood sugar measurements like HbA1c by capturing individual differences in how people's red blood cells respond to blood sugar, could potentially be used alongside existing tools to better identify which heart attack patients are at higher or lower risk of dying. This could eventually help clinicians tailor monitoring and treatment strategies, though the single-center design of the study means the findings will need to be confirmed in broader populations before clinical adoption.
Jiang H, Zhao Y, Zhao Y, Wang S, Zhai W, Liu Z. (2026). Association between hemoglobin glycation index and all-cause mortality in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1847325