Abstract 10632: A Novel Glyco-Inflammatory Healing Index for Risk Prediction After Isolated Coronary Artery Bypass Grafting: A Multicenter Retrospective Cohort Study in Patients with Diabetes

Abstract

Background: The Glyco-Inflammatory Healing Index (GIHI), calculated as HbA1c х C-reactive protein/albumin, integrates glycemic control, systemic inflammation, and nutritional status. Its prognostic value after isolated coronary artery bypass grafting (CABG) remains unclear, particularly according to diabetes status. Methods: We conducted a retrospective international multicenter cohort study of 6,262 adults undergoing isolated CABG between 2010 and 2025. Patients were stratified by diabetes status. GIHI was analyzed as a standardized continuous variable and descriptively categorized as high or low based on subgroup medians. The primary outcome was 30-day major adverse cardiovascular events (MACE), defined as all-cause mortality, myocardial infarction, stroke, or repeat revascularization. The secondary outcome included long-term all-cause mortality. Associations were assessed using Cox regression, Kaplan-Meier analysis, restricted cubic splines, subgroup analyses, and receiver operating characteristic curves. Results: Among 6,262 patients, 2,783 (44.5%) had diabetes. In diabetic patients, higher GIHI was independently associated with 30-day MACE (adjusted hazard ratio [HR] 1.45, 95% confidence interval [CI] 1.28-1.65), 30-day myocardial infarction (HR 1.27, 95% CI 1.00-1.60), 30-day mortality (HR 2.56, 95% CI 2.06-3.18), and long-term mortality (HR 2.57, 95% CI 2.33-2.83). In non-diabetic patients, GIHI was not associated with 30-day MACE but remained associated with 30-day mortality and long-term mortality. Adding GIHI improved discrimination for 30-day MACE in diabetic patients (AUC 0.65 to 0.69; p<0.001). Conclusions: GIHI independently predicts adverse postoperative outcomes after isolated CABG, with the strongest prognostic relevance in patients with diabetes.