Association of stress hyperglycemia ratio with in‐hospital new‐onset atrial fibrillation and long‐term outcomes in patients with acute myocardial infarction

Luo, Jiachen; Li, Zhiqiang; Qin, Xiaoming; Zhang, Xingxu; Liu, Xiangdong; Zhang, Wenming; Xu, Wei; Liu, Baoxin; Wei, Yidong; ,

doi:10.1002/dmrr.3726

Cited by 8 publications

(1 citation statement)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, individuals with cardiovascular diseases often exhibit metabolic disturbances due to unhealthy dietary and lifestyle habits, potentially exacerbating adverse cardiovascular outcomes [ 2 , 3 ]. Previous research has shown that elevated blood glucose levels upon hospital admission in patients with CVD are independently associated with poor prognosis [ 4 , 5 ]. However, hyperglycemia often arises from a combination of acute stress and chronic glucose levels and thus might not necessarily reflect an acute rise in glucose.…”

Section: Introductionmentioning

confidence: 99%

J-shaped relationship between stress hyperglycemia ratio and 90-day and 180-day mortality in patients with a first diagnosis of acute myocardial infarction: analysis of the MIMIC-IV database

Hu,

Chen,

Wang

et al. 2024

Diabetol Metab Syndr

View full text Add to dashboard Cite

Aims The Stress Hyperglycemia Ratio (SHR) potently predicts adverse outcomes in patients with cardiovascular and cerebrovascular diseases. However, the relationship between SHR and short-term mortality risk in patients with a first diagnosis of acute myocardial infarction (AMI) remains contentious. This study sought to understand better the relationship between SHR and short-term mortality risk in patients with a first diagnosis of AMI. Methods We conducted a cohort study using data from 1961 patients with a first diagnosis of AMI from the MIMIC-IV (version 2.2) database. Patients were divided into three groups based on SHR tertiles. The Cox proportional hazards model and a two-segmented Cox proportional hazards model were used to elucidate the nonlinear relationship between SHR in patients with a first diagnosis of AMI and mortality. Results Of the surveyed population, 175 patients (8.92%) died within 90 days, and 210 patients (10.71%) died within 180 days. After multivariate adjustments, elevated SHR levels were significantly and non-linearly associated with a higher risk of 90-day and 180-day mortality in patients with a first diagnosis of AMI, showing a J-shaped correlation with an inflection point at 0.9. Compared to participants with SHR levels below the inflection point, those with higher SHR levels had a fivefold increased risk of 90-day mortality (hazard ratio [HR] 5.74; 95% confidence interval [CI] 3.19, 10.33) and a fourfold increased risk of 180-day mortality (HR 4.56; 95% CI 2.62, 7.95). In the subgroup analysis, patients with pre-diabetes mellitus (pre-DM) and higher SHR levels had increased 90-day (HR 6.90; 95% CI 1.98, 24.02) and 180-day mortality risks (HR 5.30; 95% CI 1.96, 14.27). Conclusion In patients with a first diagnosis of AMI, there is a J-shaped correlation between SHR and 90-day and 180-day mortality, with an adverse prognostic inflection point of SHR at 0.9.

show abstract

Section: Introductionmentioning

confidence: 99%

J-shaped relationship between stress hyperglycemia ratio and 90-day and 180-day mortality in patients with a first diagnosis of acute myocardial infarction: analysis of the MIMIC-IV database

Hu,

Chen,

Wang

et al. 2024

Diabetol Metab Syndr

View full text Add to dashboard Cite

show abstract

The association between stress hyperglycemia ratio and nonalcoholic fatty liver disease among U.S. adults: A population-based study

Xi,

Liao,

et al. 2024

Nutrition, Metabolism and Cardiovascular Diseases

View full text Add to dashboard Cite

Association between stress hyperglycemia ratio and mortality in acute myocardial infarction patients with and without atrial fibrillation: a retrospective cohort study from the MIMIC-IV database

Huang,

Gao,

Huang

et al. 2024

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background The stress hyperglycemia ratio (SHR) potently predicts adverse outcomes in patients with acute myocardial infarction (AMI), and previous studies reported U-shaped relationships between SHR and adverse prognosis. However, the relationship between SHR and mortality risk in AMI patients with or without atrial fibrillation (AF) remained unknown, and which factors affect the mortality in lower SHR patients were unclear. This study aims to research the relationship between SHR and mortality risk in AMI patients with or without AF, and whether AF affects the mortality in lower SHR patients. Methods We conducted a cohort study using data from 3233 patients with a first diagnosis of AMI from the MIMIC-IV (version 2.2) database. Patients were divided into two groups based on AF. The study outcome was 1-year all-cause mortality. SHR was defined as the index calculated by the formula: SHR = (admission glucose) (mmol/L) / (1.59 * HbA1c [%] – 2.59). Results U-shaped association between SHR and all-cause mortality was found only in AMI patients with AF, not in AMI patients without AF. For AMI patients with AF, the inflection point for the curve was found to be a SHR of 1.09, either lower (OR, 0.30; 95%CI, 0.10, 0.94) or higher (OR, 3.28; 95%CI, 2.01, 5.34) SHR is associated with increased mortality. However, a linear relationship was found in patients without AF, higher (OR, 1.95; 95%CI, 1.52, 2.51) SHR is associated with increased mortality. For patients with SHR ≤ 1.09, AF increased the risk of all-cause mortality(OR, 1.50; 95%CI, 1.10, 2.05), while this effect was not found in patients with SHR > 1.09. Conclusion The association between SHR and mortality in AMI patients with or without AF is different: U-shaped association between SHR and all-cause mortality only in AMI patients with AF, not in AMI patients without AF. AF is a factor that make the difference by increasing the risk of mortality in AMI patients with low SHR. Lower SHR may increase mortality through the onset of AF. This study emphasizes avoiding “relative hypoglycemia”, SHR = 1.09 is the moderately tight glycemic control, which means glucose level is about (1.59 * HbA1c [%] – 2.59) * 1.09 mmol/L. Trial registration Clinical trial number: not applicable.

show abstract

Association of stress hyperglycemia ratio with in‐hospital new‐onset atrial fibrillation and long‐term outcomes in patients with acute myocardial infarction

Cited by 8 publications

References 35 publications

J-shaped relationship between stress hyperglycemia ratio and 90-day and 180-day mortality in patients with a first diagnosis of acute myocardial infarction: analysis of the MIMIC-IV database

J-shaped relationship between stress hyperglycemia ratio and 90-day and 180-day mortality in patients with a first diagnosis of acute myocardial infarction: analysis of the MIMIC-IV database

The association between stress hyperglycemia ratio and nonalcoholic fatty liver disease among U.S. adults: A population-based study

Association between stress hyperglycemia ratio and mortality in acute myocardial infarction patients with and without atrial fibrillation: a retrospective cohort study from the MIMIC-IV database

Contact Info

Product

Resources

About