Impact of stress hyperglycemia ratio, derived from glycated albumin or hemoglobin A1c, on mortality among ST-segment elevation myocardial infarction patients

Stress hyperglycemia ratio (SHR), associated with adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI), has several definitions. This study aims to assess the prognostic value of SHR, derived from hemoglobin A1c (HbA1c) or glycated albumin (GA), to mortality. The stud...

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Bibliographic Details
Published in:	Cardiovascular diabetology Vol. 22; no. 1; pp. 334 - 11
Main Authors:	Liao, Wang, Chen, Yuwen, Gao, Qiyue, Gan, Rongrong, Li, Ming, Liu, Zhenliang, Liang, Jiasheng, Cui, Henghua, Ren, Kaida, Liu, Yabin, Wang, Zhengdong, Jiang, Jun, Wei, Qucheng
Format:	Journal Article
Language:	English
Published:	England BioMed Central 06-12-2023 BMC
Subjects:	Age Albumin Albumins Biomarkers Blood Glucose Cardiovascular disease Death Diabetes Glucose Glycated albumin Glycated Hemoglobin Glycated hemoglobin A1c Heart attacks Hemoglobin Hospital Mortality Hospitals Humans Hyperglycemia Hyperglycemia - diagnosis Hypertension Ischemia Males Medical records Mortality Myocardial infarction Patients Percutaneous Coronary Intervention - adverse effects Prognosis Reclassification Risk Factors ST Elevation Myocardial Infarction - diagnosis ST Elevation Myocardial Infarction - therapy ST-segment elevation myocardial infarction Stress-induced hyperglycemia Treatment Outcome Trends Glycated albumin Glycated hemoglobin A1c Prognosis ST-segment elevation myocardial infarction Stress-induced hyperglycemia
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Summary:	Stress hyperglycemia ratio (SHR), associated with adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI), has several definitions. This study aims to assess the prognostic value of SHR, derived from hemoglobin A1c (HbA1c) or glycated albumin (GA), to mortality. The study comprised 1,643 STEMI patients who underwent percutaneous coronary intervention (PCI) in two centers. SHR1 was calculated using fasting blood glucose (FBG)/GA, while SHR2 was calculated using the formula FBG/(1.59*HbA1c-2.59). The primary endpoints were in-hospital death and all-cause mortality, with a median follow-up duration of 1.56 years. Higher SHR1 and SHR2 values are associated with increased risks of in-hospital death and all-cause mortality. Each standard deviation increase in SHR1 corresponded to a 39% and 22% escalation in in-hospital death and all-cause mortality, respectively. The respective increases for SHR2 were 51% and 26%. Further examinations validated these relationships as linear. Additionally, the areas under the curve (AUC) for in-hospital death were not significantly different between SHR1 and SHR2 (p > 0.05). Incorporating SHR1 or SHR2 into the base model significantly improved the discrimination and risk reclassification for in-hospital and all-cause mortality. A subgroup analysis revealed that the effects of SHR1 and SHR2 were more pronounced in patients with hypercholesteremia. SHR1 and SHR2 have emerged as robust and independent prognostic markers for STEMI patients undergoing PCI. The SHR calculation based on either HbA1c or GA can provide additional predictive value for mortality beyond traditional risk factors, helping to identify high-risk STEMI patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1475-2840 1475-2840
DOI:	10.1186/s12933-023-02061-6