Prognostic impact of stress hyperglycemia ratio in acute myocardial infarction patients with and without diabetes mellitus

Luo, Jiachen; Xu, Siling; Li, Hongqiang; Li, Zhiqiang; Gong, Mengmeng; Qin, Xiaoming; Zhang, Xingxu; Hao, Chuanzhen; Liu, Xiangdong; Zhang, Wenming; Xu, Wei; Liu, Baoxin; Wei, Yidong

doi:10.1016/j.numecd.2022.07.004

Cited by 17 publications

(19 citation statements)

References 42 publications

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“…Among diabetic and non-diabetic AMI populations, Cui et al found that 1.20 and 1.08 were optimal cut-off values for SHR in predicting 2-year mortality [ 34 ]. Luo et al found that 1.24 and 1.14 were the optimal cut-off values for SHR in diabetics and non-diabetics with AMI, respectively [ 41 ]. Additionally, among elderly AMI patients, the optimal cut-off value of the SHR for predicting in-hospital outcomes was 1.20, while 1.32 for predicting in-hospital mortality [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries

Abdu

Galip

et al. 2023

Cardiovasc Diabetol

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Background Stress hyperglycemia ratio (SHR) is a novel biomarker of true acute hyperglycemia condition and is associated with a worse prognosis in patients with myocardial infarction (MI). However, the effects of SHR in the setting of MI with non-obstructive coronary arteries (MINOCA) have not been investigated. This study aimed to explore the association between SHR and long-term clinical outcomes among MINOCA patients. Methods A total of 410 MINOCA patients were included in the final analysis of this study. The patients were divided into three groups based on the SHR tertiles: [SHR1 group (SHR ≤ 0.73), (n = 143); SHR2 group (SHR 0.73–0.84), n = 131; and SHR3 group (SHR ≥ 0.84), n = 136]. Follow-up for major adverse cardiovascular events (MACE) was conducted on all patients. Cox regression and Kaplan–Meier curve analysis were used to evaluate the relationship between SHR and MACE. The receiver operating curve (ROC) analysis was applied to obtain the optimal cut-off value of SHR for predicting clinical MACE. Results A total of 92 patients developed MACE during the mean 34 months of follow-up. A significant increase in MACE was observed in the SHR3 group compared to the SHR1 and SHR2 groups (35.3% vs. 15.4% and 16.8%, respectively; P < 0.001). The Kaplan–Meier curves demonstrate that SHR3 patients had the highest MACE risk compared to SHR1 and SHR2 patients (log-rank P < 0.001). In addition, when both SHR tertiles and diabetes status were considered, those with SHR3 and diabetes had the highest hazard of MACE (log-rank P < 0.001). Multivariate Cox regression analysis showed that the SHR3 is associated with a 2.465-fold increase in the risk of MACE (adjusted HR, 2.465; 95% CI 1.461–4.159, P = 0.001). The ROC curve analysis showed that the optimal SHR cut-off value for predicting clinical MACE among MINOCA was 0.86. Conclusion Our data indicates, for the first time, that SHR is independently associated with poor long-term prognosis in patients suffering from MINOCA. The optimal SHR cut-off value for predicting clinical MACE among MINOCA patients was 0.86. These findings suggest that SHR may play a potential role in the cardiovascular risk stratification of the MINOCA population.

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Section: Discussionmentioning

confidence: 99%

Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries

Abdu

Galip

et al. 2023

Cardiovasc Diabetol

View full text Add to dashboard Cite

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“…Moreover, it has been reported that, unlike the admission blood glucose, the SHR is an independent predictor of in-hospital mortality after AMI and improves the predictability of prognostic models containing the Global Registry of Acute Coronary Events (GRACE) score [ 6 ]. Similarly, Luo et al reported that adding SHR to the GRACE score significantly improved its post-MI risk stratification performance among patients with diabetes [ 31 ]. These studies suggested a strong prognostic value of stress hyperglycemia, which may help identify ACS patients with a higher risk of subsequent adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic implication of stress hyperglycemia in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Wang

Cao

et al. 2023

Cardiovasc Diabetol

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Background It is now understood that stress hyperglycemia is associated with adverse outcomes in hospitalized patients. Herein, we aimed to investigate the association between stress hyperglycemia and mortality risk in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). Methods This cohort study comprised 5190 ACS patients who underwent PCI from the Cardiovascular Center Beijing Friendship Hospital Database Bank (CBDBANK) from January 2013 to January 2021. Stress hyperglycemia was defined by the glucose/glycated albumin (GA) ratio, calculated as admission fasting plasma glucose divided by GA. The patients were divided into four groups according to glucose/GA ratio quartiles (Q1-Q4). Cox proportional hazards regression and restricted cubic spline were used to evaluate the association between glucose/GA ratio and all-cause and cardiovascular mortality. Results During a median follow-up of 4.0 years, the number of all-cause deaths was 313 (6.0%) and cardiovascular-associated deaths was 177 (3.4%). After adjustment for potential confounders, the risk of all-cause mortality increased in the lowest (HR, 1.43; 95% CI, 1.01–2.03) and highest (HR, 1.51; 95% CI, 1.03–2.21) glucose/GA ratio quartiles compared to Q2. The restricted cubic splines showed that the association between glucose/GA ratio and all-cause mortality was U-shaped after full adjustment (Pnonlinear = 0.008). Similar results were observed for cardiovascular mortality. In subgroup analyses according to diabetes status, the U-shaped relationship was only significant in patients with diabetes mellitus. Conclusion In ACS patients undergoing PCI, low and high glucose/GA ratio values were associated with an increased all-cause and cardiovascular mortality, especially in those with diabetes mellitus.

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“…To calculate the average chronic glucose levels, we used the following formula: [(28.7*HbA1c%) − 46.7] /18.8 [ 10 ]. To calculate SHR, we divided the fasting blood glucose on the first day of ICU admission by the estimated mean chronic blood glucose and expressed the result as a percentage.…”

Section: Methodsmentioning

confidence: 99%

Association of hyperglycemia ratio and ventricular arrhythmia in critically ill patients admitted to the intensive care unit

Shen¹,

Wang²,

Zhang³

et al. 2023

BMC Cardiovasc Disord

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Introduction The relationship between relative hyperglycemia and ventricular arrhythmia (VA) in critically ill patients admitted to intensive care units (ICU) remains unclear. This study aims to investigate the association between stress hyperglycemia ratio (SHR) and VA in this population. Methods: This retrospective and observational study analyzed data from 4324 critically ill patients admitted to the ICU, obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The SHR was calculated as the highest blood glucose level during the first 24 h of ICU admission divided by the admission blood glucose level. Based on the optimal cut-off values under the receiver operating characteristic curve, patients were stratified into high SHR (≥ 1.31) and low SHR (< 1.31) group. To investigate the impact of diabetes mellitus (DM) on the outcome, patients were stratified as low SHR/DM; low SHR/non-DM; high SHR/DM, and high SHR/non-DM. Restricted cubic spline (RCS) and logistic regression analysis were performed to analyze the relationship between SHR and VA. Results A total of 4,324 critically ill patients were included in this retrospective and observational study. The incidence of VA was higher in the high SHR group. Multiple-adjusted RCS revealed a “J-shaped” correlation between SHR and VA morbidity. The logistic regression model demonstrated that high SHR was associated with VA. The high SHR/non-DM group had a higher risk of VA than other groups stratified based on SHR and DM. Subgroup analysis showed that high SHR was associated with an increased risk of VA in patients with coronary artery disease. Conclusion High SHR is an independent risk factor and has potential as a biomarker of higher VT/VF risk in ICU-admitted patients.

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Prognostic impact of stress hyperglycemia ratio in acute myocardial infarction patients with and without diabetes mellitus

Cited by 17 publications

References 42 publications

Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries

Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries

Prognostic implication of stress hyperglycemia in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Association of hyperglycemia ratio and ventricular arrhythmia in critically ill patients admitted to the intensive care unit

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