The predictive value of stress hyperglycemia ratio on in-hospital mortality and mechan-ical complications in patients with acute ST-segment elevation myocardial infarction
10.20039/j.cnki.1007-3949.2025.05.008
- VernacularTitle:应激性高血糖比值对急性ST段抬高型心肌梗死患者院内死亡及机械性并发症的预测价值
- Author:
Shiheng ZHOU
1
;
Zhen TAN
1
;
Lei LIU
1
;
Kai TANG
1
;
Xuejun DENG
1
;
Yijun LIU
1
Author Information
1. 遂宁市中心医院心血管内科,四川省遂宁市 629000
- Publication Type:Journal Article
- Keywords:
stress hyperglycemia ratio;
acute ST-segment elevation myocardial infarction;
mechanical compli-cations;
in-hospital mortality
- From:
Chinese Journal of Arteriosclerosis
2025;33(5):427-434
- CountryChina
- Language:Chinese
-
Abstract:
Aim To explore the predictive value of stress hyperglycemia ratio(SHR)for in-hospital mortality and mechanical complications in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study constituted a retrospective investigation that collected 995 patients diagnosed with acute STEMI at Suining Central Hospital from June 2019 to July 2023.Comparisons of baseline data were conducted using t-test,Mann-Whitney U test and chi-square test;Logistic regression was used to analyze the association between SHR and the risk of in-hospital mortality and mechanical complications in acute STEMI patients;Restricted cubic spline analysis based on the Logistic re-gression model was utilized to explore non-linear relationship between SHR and the risk of in-hospital mortality and mechan-ical complications;ROC curve was used to evaluate the diagnostic efficacy of SHR;Subgroup analysis was used to assess the predictive efficacy of SHR in each subgroup.Results Patients with high SHR had a significantly higher cardiovas-cular mortality(P=0.007).High SHR was an independent risk factor for in-hospital all-cause mortality(Model 1:OR=3.085,95% CI:1.719~5.538,P<0.001;Model 2:OR=2.738,95% CI:1.4439~5.132,P=0.002),cardiovascular mortality(Model 1:OR=3.406,95% CI:1.869~6.228,P<0.001;Model 2:OR=3.053,95% CI:1.595~5.817,P<0.001),ventricular aneurysm(Model 1:OR=3.203,95%CI:1.665~6.069,P<0.001;Model2:OR=3.93,95%CI:1.785~8.663,P<0.001),cardiac rupture(Model 1:OR=2.461,95% CI:1.389~4.312,P=0.002;Model 2:OR=2.302,95% CI:1.214~4.274,P=0.009)and composite endpoint(Model 1:OR=3.719,95% CI:2.226~6.332,P<0.001;Model 2:OR=2.919,95% CI:1.576~5.405,P<0.001)in patients with acute STEMI.SHR was positively correlated in a linear relationship with the risk of in-hospital all-cause mortality(P for non-linearity=0.250),cardiovascular mortality(P for non-linearity=0.129),ventricular aneurysm(P for non-linearity=0.588),cardiac rupture(P for non-linearity=0.787)and composite endpoint(P for non-linearity=0.399).The SHR had excellent diagnostic efficacy for in-hospital all-cause mortality(AUC=0.694),cardiovascular mortality(AUC=0.697),ventricular aneurysm(AUC=0.706),cardiac rupture(AUC=0.667)and composite endpoint(AUC=0.730),meanwhile SHR predicted efficacy consistently across subgroups.Conclusions High SHR is an independent risk factor for in-hospital all-cause mortality,cardiovascular mortality and cardiac mechanical complications in patients with a-cute STEMI.SHR holds significant predictive value for the prognosis of patients with STEMI.