Observational studyCardiovascular diabetology2024
Effects of the stress hyperglycemia ratio on long-term mortality in patients with triple-vessel disease and acute coronary syndrome.
Observational study in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- 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
- Association Between Stress Hyperglycemia Ratio and Death in Patients With Moderate to Severe Tricuspid Regurgitation.Journal of the American Heart Association · 2026Observational
- Stress Hyperglycemia Ratio Predicts 28-Day Mortality in Patients with AMI Cardiogenic Shock: Insights from a Large-Scale Cohort.Journal of clinical medicine · 2026Article
- Contrast-Associated Acute Kidney Injury and Mortality Risk After Coronary Angiography for Acute Coronary Syndromes: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Article
- 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
- The relationship between Gensini score and rates of 30-day mortality in acute coronary syndrome patients in China.BMC cardiovascular disorders · 2025Article
- Stress hyperglycemia ratio and albumin predict in-hospital outcomes in patients with acute myocardial infarction: a cohort study.Scientific reports · 2025Observational
- Association between SHR and mortality in critically ill patients with CVD: a retrospective analysis and machine learning approach.Diabetology & metabolic syndrome · 2025Article
- U-shaped association of the stress hyperglycemia ratio with all-cause mortality and premature death in patients with cardiovascular disease: a cohort study.Diabetology & metabolic syndrome · 2025Article
- Stress hyperglycemia ratio as a biomarker for early mortality risk stratification in cardiovascular disease: a propensity-matched analysis.Cardiovascular diabetology · 2025Observational
- Relationship between stress hyperglycemia ratio and the incidence of atrial fibrillation in patients after coronary artery bypass grafting: a retrospective study based on the MIMIC-IV database.Diabetology & metabolic syndrome · 2025Article
- Association between stress hyperglycemia ratio (SHR) and the risk of acute kidney injury in patients with chronic kidney disease: analysis of the MIMIC-IV database.BMC nephrology · 2025Article
- Prognostic significance of stress hyperglycemia ratio in patients with type 2 diabetes mellitus and acute coronary syndromes.Thrombosis journal · 2025Article
- Left atrioventricular coupling and left atrial abnormality in patients with acute myocardial infarction with and without hyperglycemia assessed with 3.0T cardiac magnetic resonance imaging feature tracking.Quantitative imaging in medicine and surgery · 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
- The stress hyperglycemia ratio as a predictor of short- and long-term mortality in patients with acute brain injury: a retrospective cohort study.Frontiers in neurology · 2025Article
- The role of SHR in risk stratification for long-term prognosis in patients with coronary artery disease: findings from a large cohort study.Frontiers in endocrinology · 2025Observational
- Stress hyperglycemia is associated with early neurologic deterioration in patients with acute ischemic stroke after intravenous thrombolysis without hemorrhagic transformation.Diabetology & metabolic syndrome · 2024Article
Corrections and comments
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Authors and funding
17 authors at 2 institutions in 1 country.
Funding
Abstract
aimsRisk assessment for triple-vessel disease (TVD) remain challenging. Stress hyperglycemia represents the regulation of glucose metabolism in response to stress, and stress hyperglycemia ratio (SHR) is recently found to reflect true acute hyperglycemic status. This study aimed to evaluate the prognostic value of SHR and its role in risk stratification in TVD patients with acute coronary syndrome (ACS).
methodsA total of 3812 TVD patients with ACS with available baseline SHR measurement were enrolled from two independent centers. The endpoint was cardiovascular mortality. Cox regression was used to evaluate the association between SHR and cardiovascular mortality. The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) II (SSII) was used as the reference model in the model improvement analysis.
resultsDuring a median follow-up of 5.1 years, 219 (5.8%) TVD patients with ACS suffered cardiovascular mortality. TVD patients with ACS with high SHR had an increased risk of cardiovascular mortality after robust adjustment for confounding (high vs. median SHR: adjusted hazard ratio 1.809, 95% confidence interval 1.160-2.822, P = 0.009), which was fitted as a J-shaped pattern. The prognostic value of the SHR was found exclusively among patients with diabetes instead of those without diabetes. Moreover, addition of SHR improved the reclassification abilities of the SSII model for predicting cardiovascular mortality in TVD patients with ACS.
conclusionsThe high level of SHR is associated with the long-term risk of cardiovascular mortality in TVD patients with ACS, and is confirmed to have incremental prediction value beyond standard SSII. Assessment of SHR may help to improve the risk stratification strategy in TVD patients who are under acute stress.
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