ArticleCardiovascular diabetology2022
Association of stress hyperglycemia ratio and in-hospital mortality in patients with coronary artery disease: insights from a large cohort study.
Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled it.
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Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Stress hyperglycemia ratio in coronary artery disease: a systematic review and meta-analysis of severity and prognosis.Cardiovascular diabetology · 2026Pooled it
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- The association between the stress hyperglycaemia ratio and mortality in cardiovascular disease: a meta-analysis and systematic review.Cardiovascular diabetology · 2024Pooled it
- CAMI-DM: Development and validation of a multi-algorithm model for in-hospital mortality risk prediction in diabetic patients with acute myocardial infarction - The China acute myocardial infarction registry.PLOS digital health · 2026Article
- Association Between Stress Hyperglycemia Ratio and Cardiovascular Outcomes in Patients Who Underwent Complex Percutaneous Coronary Intervention According to Different Glycemic Status.Journal of the American Heart Association · 2026Article
- Correlation between SHR and 28-day all-cause mortality risk in patients with spontaneous intracerebral hemorrhage.BMC neurology · 2026Article
- Stress hyperglycemia ratio improves 28-day mortality prediction beyond GRACE score in critically ill patients with acute coronary syndrome: a retrospective cohort study from MIMIC-IV.BMC cardiovascular disorders · 2026Article
- Stress Hyperglycemia Ratio and the Risk of Sepsis in Patients With Heart Failure: Retrospective Cohort Study From Medical Information Mart for Intensive Care-IV.JMIR medical informatics · 2026Article
- The Role of Serum Biomarkers for the Differential Diagnosis and Prognostic Assessment of Myocardial Infarction with Non-Obstructive Coronary Arteries: A Narrative Review.Journal of clinical medicine · 2026Review
- Relation of the stress hyperglycaemia ratio to residual risk in anticoagulated patients with atrial fibrillation: A report from the prospective Murcia AF Project III cohort.Diabetes, obesity & metabolism · 2026Article
- Unveiling the relationship between stress-hyperglycemia ratio and cardiometabolic multimorbidity risk using interpretable machine learning.European journal of medical research · 2026Article
- Relationship between stress hyperglycemia ratio and gastrointestinal bleeding and mortality after coronary artery bypass grafting: a multicenter cohort study.Frontiers in cardiovascular medicine · 2026Article
- Predictive value of stress hyperglycemia ratio for the risk of heart failure during hospitalization in STEMI patients undergoing emergency percutaneous coronary intervention: a single-center retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Prognostic significance of stress hyperglycemia ratio in coronary microvascular dysfunction among chronic coronary syndrome patients.Frontiers in cardiovascular medicine · 2026Article
- Stress hyperglycemia ratio and long-term prognosis in patients with acute myocardial infarction undergoing percutaneous coronary intervention: evidence for an J-shaped association.Journal of geriatric cardiology : JGC · 2025Article
- A study on predicted in-hospital mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-IV database.BMC medical informatics and decision making · 2025Article
- Association between stress hyperglycemia ratio and all-cause mortality in patients with coronary heart disease.BMC cardiovascular disorders · 2025Article
- Stress hyperglycemia ratio as an independent predictor of acute kidney injury in critically ill patients with acute myocardial infarction: a retrospective U.S. cohort study.Renal failure · 2025Article
- The additive effect of hemoglobin glycation index and glycemic variability to predict mortality in cardiac intensive care patients with and without diabetes.Scientific reports · 2025Article
- Association between SHR and mortality in critically ill patients with CVD: a retrospective analysis and machine learning approach.Diabetology & metabolic syndrome · 2025Article
10 more citing papers are in PubMed but not listed here.
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Abstract
backgroundStress hyperglycemia is strongly associated with poor clinical outcomes in patients with acute coronary syndrome (ACS). Recently, the stress hyperglycemia ratio (SHR) has been proposed to represent relative hyperglycemia. Studies regarding the relationship between SHR and mortality in coronary artery disease (CAD) are limited. This study aimed to clarify the association between SHR and in-hospital mortality in patients with CAD.
methodsA total of 19,929 patients with CAD who were hospitalized in Beijing Hospital were enrolled in this study. Patients with an estimated glomerular filtration rate < 30 ml/min, cancer, or missing blood glucose/HbA1c data were excluded; therefore, 8,196 patients were included in the final analysis. The patients were divided into three groups based on tertiles of SHR: T1 group (SHR < 0.725, n = 2,732), T2 group (0.725 ≤ SHR < 0.832, n = 2,730), and T3 group (SHR ≥ 0.832, n = 2,734). The primary endpoint was in-hospital mortality.
resultsThe overall in-hospital mortality rate was 0.91% (n = 74). After adjusting for covariates, SHR was significantly associated with in-hospital mortality in patients with CAD [odds ratio (OR) = 17.038; 95% confidence interval (CI) = 9.668-30.027; P < 0.001], and the T3 group had a higher risk of in-hospital mortality (OR = 4.901; 95% CI = 2.583-9.297; P < 0.001) compared with T1 group. In the subgroup analysis, the T3 group had an increased risk of mortality among patients with pre-diabetes mellitus (pre-DM) (OR = 9.670; 95% CI = 1.886-49.571; P = 0.007) and diabetes mellitus (DM) (OR = 5.023; 95% CI = 2.371-10.640; P < 0.001) after adjustments for covariates. The relationship between SHR and in-hospital mortality among patients with ACS and chronic coronary syndrome was consistent with the main finding. SHR and in-hospital mortality exhibited a dose-response relationship, and the risk of in-hospital mortality increased when the SHR index was above 1.20. Moreover, the area under the curve of SHR for predicting in-hospital mortality in patients with CAD was 0.741.
conclusionSHR is significantly associated with in-hospital mortality in patients with CAD. SHR may be an effective predictor of in-hospital mortality in patients with CAD, especially for those with pre-DM and DM.
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