ArticleCardiovascular diabetology2023
Association of stress hyperglycemia ratio and poor long-term prognosis in patients with myocardial infarction with non-obstructive coronary arteries.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Stress hyperglycemia ratio in coronary artery disease: a systematic review and meta-analysis of severity and prognosis.Cardiovascular diabetology · 2026Pooled it
- Predictive performance of stress hyperglycemia ratio for poor prognosis in critically ill patients: a systematic review and dose-response meta-analysis.European journal of medical research · 2025Pooled 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
- Association of stress hyperglycemia ratio on right ventricular dysfunction and biventricular coupling in patients with acute coronary syndrome assessed by CMR feature tracking: a cross-sectional study.Quantitative imaging in medicine and surgery · 2026Article
- Association Between Stress Hyperglycemia Ratio and Death in Patients With Moderate to Severe Tricuspid Regurgitation.Journal of the American Heart Association · 2026Observational
- Correlation between SHR and 28-day all-cause mortality risk in patients with spontaneous intracerebral hemorrhage.BMC neurology · 2026Article
- Combined assessment of triglyceride-glucose index and stress hyperglycemia ratio to predict all-cause mortality in critically ill patients with intracerebral hemorrhage.BMC neurology · 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
- Acute-to-chronic glycemic ratio: a promising biomarker for prognosis of diabetic foot ulcers in a multi-center cohort study.Diabetology & metabolic syndrome · 2026Article
- Prognostic significance of stress hyperglycemia ratio in coronary microvascular dysfunction among chronic coronary syndrome patients.Frontiers in cardiovascular medicine · 2026Article
- Association Between Stress Hyperglycemia Ratio and Coronary Slow Flow Phenomenon in Patients with MINOCA.International journal of general medicine · 2026Article
- Prognostic value of stress hyperglycemia ratio in patients with different plaque types with acute myocardial infarction.European journal of medical research · 2025Article
- Accelerated biological aging mediates the associations of stress hyperglycemia ratio (SHR) with mortality in type 2 diabetes and obesity (diabesity).Cardiovascular diabetology · 2025Article
- The Stress Hyperglycemia Ratio as a Predictor of Clinical Outcomes in Acute Pancreatitis: A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Stress hyperglycemia ratio and its correlation with long-term prognosis in ACS patients with chronic kidney disease: a retrospective study.BMC cardiovascular disorders · 2025Article
- The prognostic significance of stress hyperglycemia ratio for all-cause and cardiovascular mortality in metabolic syndrome patients: prospective cohort study.Acta diabetologica · 2025Article
- Association of stress hyperglycemia ratio with short-term and long-term prognosis in patients undergoing coronary artery bypass grafting across different glucose metabolism states: a large-scale cohort study.Cardiovascular diabetology · 2025Observational
- Clinical characteristics and prognosis of myocardial infarction with nonobstructive coronary arteries evaluated by optical coherence tomography.Scientific reports · 2025Article
- Assessment of stress hyperglycemia ratio to predict all-cause mortality in patients with critical cerebrovascular disease: a retrospective cohort study from the MIMIC-IV database.Cardiovascular diabetology · 2025Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStress hyperglycemia ratio (SHR) is a novel biomarker of true acute hyperglycemia condition and is associated with a worse prognosis in patients with myocardial infarction (MI). However, the effects of SHR in the setting of MI with non-obstructive coronary arteries (MINOCA) have not been investigated. This study aimed to explore the association between SHR and long-term clinical outcomes among MINOCA patients.
methodsA total of 410 MINOCA patients were included in the final analysis of this study. The patients were divided into three groups based on the SHR tertiles: [SHR1 group (SHR ≤ 0.73), (n = 143); SHR2 group (SHR 0.73-0.84), n = 131; and SHR3 group (SHR ≥ 0.84), n = 136]. Follow-up for major adverse cardiovascular events (MACE) was conducted on all patients. Cox regression and Kaplan-Meier curve analysis were used to evaluate the relationship between SHR and MACE. The receiver operating curve (ROC) analysis was applied to obtain the optimal cut-off value of SHR for predicting clinical MACE.
resultsA total of 92 patients developed MACE during the mean 34 months of follow-up. A significant increase in MACE was observed in the SHR3 group compared to the SHR1 and SHR2 groups (35.3% vs. 15.4% and 16.8%, respectively; P < 0.001). The Kaplan-Meier curves demonstrate that SHR3 patients had the highest MACE risk compared to SHR1 and SHR2 patients (log-rank P < 0.001). In addition, when both SHR tertiles and diabetes status were considered, those with SHR3 and diabetes had the highest hazard of MACE (log-rank P < 0.001). Multivariate Cox regression analysis showed that the SHR3 is associated with a 2.465-fold increase in the risk of MACE (adjusted HR, 2.465; 95% CI 1.461-4.159, P = 0.001). The ROC curve analysis showed that the optimal SHR cut-off value for predicting clinical MACE among MINOCA was 0.86.
conclusionOur data indicates, for the first time, that SHR is independently associated with poor long-term prognosis in patients suffering from MINOCA. The optimal SHR cut-off value for predicting clinical MACE among MINOCA patients was 0.86. These findings suggest that SHR may play a potential role in the cardiovascular risk stratification of the MINOCA population.
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