Stress Hyperglycemia Ratio Independent Predictor of In-Hospital MACCE in Acute STEMI

China: A recent study published in BMC Cardiovascular Disorders Journal has revealed that the stress hyperglycemia ratio (SHR) is a significant and independent predictor of in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ST-segment elevation myocardial infarction (STEMI) particularly in nondiabetic patients.

The study, which enrolled 1,944 patients within 24 hours of a new STEMI diagnosis calculated SHR by dividing the blood glucose level at admission by the estimated average glucose. MACCE was defined as acute cerebral infarction, mechanical complications of myocardial infarction, cardiogenic shock, and all-cause death.

Propensity score matching was used to balance confounding factors, and logistic regression was employed to identify potential predictive factors for MACCE. After 1:1 matching, a total of 276 patients were included in the final analysis, with the confounding factors balanced between the MACCE and non-MACCE groups.

The study revealed the following clinical findings:

1. Stress hyperglycemia ratio (SHR) was found to be an independent predictor of in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) in patients with ST-segment elevation myocardial infarction (STEMI).
2. Odds ratio for SHR was 10.06 indicating its predictive accuracy for in-hospital MACCE, patients with higher SHR values were 10 times more likely to experience MACCE compared to those with lower SHR values.
3. Blood glucose at admission was not found to be a significant predictor of MACCE.
4. SHR was also identified as an independent predictor for in-hospital MACCE in non-diabetic patients with STEMI, with an odds ratio of 11.26.

"These findings suggest that SHR could serve as a valuable tool in risk assessment for patients with acute STEMI, especially in those who are not diagnosed with diabetes," said Dr. Wen Guo, the lead author of the study.

The study highlights the importance of SHR as an independent predictor of in-hospital MACCE in patients with acute STEMI, with a particular emphasis on its potential in nondiabetic patients. Further research and validation of these findings could lead to the incorporation of SHR into clinical practice for risk stratification, ultimately improving patient outcomes.

Reference:

Guo, W., Zhu, J., & Liu, W. (2023). Stress hyperglycemia ratio: an independent predictor for in-hospital major adverse cardiovascular and cerebrovascular events in patients with st-segment elevation myocardial infarction. BMC Cardiovascular Disorders, 23(1), 195. https://doi.org/10.1186/s12872-023-03219-6