Stress hyperglycemia ratio closely related to the progression of non target coronary lesions, finds study
Researchers have found in a new study that stress hyperglycemia ratio (SHR) is highly correlated with the progression of non-target coronary lesions in patients with acute coronary syndrome (ACS). Though SHR has been known as one of the indicators in cardiovascular complications, the role of SHR in NTL progression has remained obscure until now. This study was recently published in BMC Diabetology and Metabolic Syndrome by Liu S. and colleagues.
This was a retrospective analysis of data from 1,234 ACS patients who received the stent implantation and follow-up coronary angiography between January 2019 and January 2024 at Zhongda Hospital. Patients were separated into a progression group and a non-progression group based on the findings of follow-up angiography. Logistic regression models, RCS analysis, and machine learning algorithms (LightGBM, decision tree, and XGBoost) were applied to examine whether SHR is correlated with NTL progression. Predictive models included SHR, number and severity of NTLs, hypertension, and high-density lipoprotein cholesterol (HDL-c).
Main Outcomes
• A total of 1,234 patients were reviewed. Of those, 29.1% had progressed NTLs.
• SHR was found as an independent predictor of NTL progression (p< 0.001). The adjusted OR of SHR was 2.12 with a 95% CI (1.30–3.44, p= 0.003).
• RCS analysis showed a near-linear relationship between SHR and NTL progression, with risks increasing substantially at SHR > 0.96 and stabilizing at SHR > 1.36 (p= 0.0047).
• The best performance was achieved by a hybrid predictive model combining logistic regression and XGBoost, with an AUC of 0.78 (95% CI: 0.72–0.85).
• Subgroup analysis showed that SHR at increased levels was a more powerful predictor of disease in non-diabetic patients (OR = 3.76, p= 0.007) as compared to diabetic patients (OR = 1.69, p= 0.083).
Researchers concluded that stress hyperglycemia ratio is an important predictor of non-target lesion progression in ACS patients, with the strongest associations observed in non-diabetic individuals. This finding opens new avenues for optimizing long-term management strategies for NTLs post-PCI.
Reference:
Liu, S., Wu, Z., Yan, G. et al. Relationship between stress hyperglycemia ratio and progression of non target coronary lesions: a retrospective cohort study. Diabetol Metab Syndr 17, 27 (2025).https://doi.org/10.1186/s13098-024-01575-7
