Stress hyperglycemia ratio independently tied to poor prognosis in MINOCA patients
China: According to a study published in Cardiovascular Diabetology, researchers have concluded that Stress hyperglycemia ratio (SHR) is independently associated with poor long-term prognosis in patients suffering from MI with non-obstructive coronary arteries (MINOCA).
It is already known that SHR is a novel biomarker of true acute hyperglycemia condition. It makes the prognosis worst in Myocardial Infarction (MI) patients. There is a lack of data on SHR effects in the setting of MI with non-obstructive coronary arteries (MINOCA), and it needs to be investigated.
Considering this, a study was conducted by a team of researchers led by Fuad A. Abdu from the Department of Cardiology at Shanghai Tenth People’s Hospital from Tongji University School of Medicine to explore “What is the association between SHR and long-term clinical outcomes among MINOCA patients?”
The study summary includes the following:
- The study had 410 MINOCA patients in the final analysis.
- There were three groups in which the patients were divided based on the SHR tertiles.
- SHR1 group, SHR2 group and SHR3 group had 143, 131 and 136 patients, respectively.
- The follow-up was done on all patients for major adverse cardiovascular events (MACE).
- The researchers used Cox regression, Kaplan–Meier curve analysis and receiver operating curve (ROC) analysis.
- The mean follow-up was of 34 months.
- Ninety-two patients developed MACE.
- SH3 had a significant increase in MACE than SHR1 and SHR2 groups (35.3% vs 15.4% and 16.8%).
- SHR3 patients had the highest MACE risk than SHR1 and SHR2 patients as Kaplan–Meier curves.
- Patients with SHR3 and diabetes had the highest hazard of MACE.
- SHR3 tied to a 2.465-fold increase in the MACE risk having adjusted H.R. of 2.465
The optimal SHR cut-off value for predicting clinical MACE among MINOCA patients was 0.86. SHR may play a potential role in the cardiovascular risk stratification of the MINOCA population.
The strength of the study includes physicians can use the information provided to follow up on selected patients more closely, increase the intensity of their goal-directed medical treatment, control their risk factors, and improve the quality of life among patients with MINOCA.
The limitations are retrospective design, small sample size, lack of inflammatory markers, did not consider other adverse outcomes.
Further reading:
Abdu, F.A., Galip, J., Qi, P. et al. Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries. Cardiovasc Diabetol 22, 11 (2023). https://doi.org/10.1186/s12933-023-01742-6
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