Stress hyperglycemia ratio and long-term prognosis in patients with acute myocardial infarction undergoing percutaneous cor-onary intervention:evidence for an J-shaped association
Ning WANG
Yi-Shuo XU
Xue FENG
Ming ZENG
Xi CHEN
Bo YU
Jun-Jie KOU
Department of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China;State Key Lab-oratory of Frigid Zone Cardiovascular Diseases(SKLFZCD),Harbin Medical University,Harbin,China;Key Labora-tory of Myocardial Ischemia,Ministry of Education,Harbin Medical University,Harbin,China
摘要：BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress.This study assessed the SHR and long-term prognosis of patients with AMI.
METHODS This study was a post-hoc analysis based on the prospective,multicenter OPTIMAL registry( number:NCT03084991).A total of 3384 consecutive patients who underwent percutaneous coronary intervention(PCI)at Departme-nt of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China were included in the present analysis after exclu-sions.Patients were stratified into quartiles according to the SHR.The primary endpoint was cardiovascular death,with all-cause death and major adverse cardiovascular events as secondary endpoints.The median follow-up duration was 24.1 months,with a completion rate of 99.5%.
RESULTS Kaplan-Meier survival curves showed progressively worse survival across SHR quartiles(log-rank P<0.001),with patients in Q4(SHR≥1.34)experiencing the highest risk.Multivariate Cox regression analysis confirmed that the SHR was an independent predic-tor of cardiovascular death[hazard ratio(HR)=1.56],all-cause death(HR=1.48),and major adverse cardiovascular events(HR=1.34)for Q4(SHR≥1.34)versus Q2(SHR:0.93-1.11).Restricted cubic spline analysis revealed a J-shaped association between SHR and outcomes,with the lowest risk observed at an SHR of approximately 1.0.
CONCLUSIONS The SHR is an independent predictor of long-term adverse outcomes in patients with AMI undergoing PCI,suppor-ting its use for early risk stratification and glycemic management.
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论文发表日期：2025-12-30
在线出版日期：2026-01-09（本平台首次上网日期，不代表文献的发表时间）
页数：11( 981-991 )