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:

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). 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.Blood glucose at admission was not found to be a
significant predictor of MACCE.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