Observational studyCardiovascular diabetology2024
High stress hyperglycemia ratio predicts adverse clinical outcome in patients with coronary three-vessel disease: a large-scale cohort study.
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 27 papers, 5 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prognostic significance of stress hyperglycemia ratio in patients undergoing percutaneous coronary intervention: a dose-response meta-analysis.BMJ open diabetes research & care · 2026Pooled it
- Post-PCI outcomes in women with acute coronary syndrome: a systematic review and meta-analysis of risk factors.BMC cardiovascular disorders · 2026Pooled it
- 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
- Stress Hyperglycemia Ratio Predicts 28-Day Mortality in Patients with AMI Cardiogenic Shock: Insights from a Large-Scale Cohort.Journal of clinical medicine · 2026Article
- Association between admission blood glucose and atypical angina in patients with coronary artery disease.BMC cardiovascular disorders · 2026Article
- Unveiling the relationship between stress-hyperglycemia ratio and cardiometabolic multimorbidity risk using interpretable machine learning.European journal of medical research · 2026Article
- Association between single-point insulin sensitivity estimator and three-vessel coronary disease: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Early relative glycemic stress trajectories identify a high-risk metabolic phenotype in critically ill patients with atherosclerotic cardiovascular disease: a dual-cohort study.Frontiers in endocrinology · 2026Article
- The role of stress hyperglycemia in in-hospital new-onset atrial fibrillation among patients with acute myocardial infarction: a narrative review.Frontiers in cardiovascular medicine · 2026Review
- Association Between Stress Hyperglycemia Ratio and Coronary Slow Flow Phenomenon in Patients with MINOCA.International journal of general 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
- Association between stress hyperglycemia ratio and all-cause mortality in patients with coronary heart disease.BMC cardiovascular disorders · 2025Article
- C-reactive protein-triglyceride glucose index in predicting three-vessel coronary artery disease risk: a retrospective study using machine learning approaches.Annals of medicine · 2025Article
- Relative hyperglycemia and new-onset atrial fibrillation after coronary artery bypass grafting: a focus on stress hyperglycemia ratio.BMC cardiovascular disorders · 2025Article
- Article
- SGLT2 Inhibitors: From Structure-Effect Relationship to Pharmacological Response.International journal of molecular sciences · 2025Review
- Postdischarge cancer and mortality in patients with coronary artery disease: a retrospective cohort study.Journal of geriatric cardiology : JGC · 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
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundCoronary three-vessel disease (CTVD) accounts for one-third of the overall incidence of coronary artery disease, with heightened mortality rates compared to single-vessel lesions, including common trunk lesions. Dysregulated glucose metabolism exacerbates atherosclerosis and increases cardiovascular risk. The stress hyperglycemia ratio (SHR) is proposed as an indicator of glucose metabolism status but its association with cardiovascular outcomes in CTVD patients undergoing percutaneous coronary intervention (PCI) remains unclear.
methods10,532 CTVD patients undergoing PCI were consecutively enrolled. SHR was calculated using the formula: admission blood glucose (mmol/L)/[1.59×HbA1c (%)-2.59]. Patients were divided into two groups (SHR Low and SHR High) according to the optimal cutoff value of SHR. Multivariable Cox regression models were used to assess the relationship between SHR and long-term prognosis. The primary endpoint was cardiovascular (CV) events, composing of cardiac death and non-fatal myocardial infarction (MI).
resultsDuring the median follow-up time of 3 years, a total of 279 cases (2.6%) of CV events were recorded. Multivariable Cox analyses showed that high SHR was associated with a significantly higher risk of CV events [Hazard Ratio (HR) 1.99, 95% Confidence interval (CI) 1.58-2.52, P < 0.001). This association remained consistent in patients with (HR 1.50, 95% CI 1.08-2.10, P = 0.016) and without diabetes (HR 1.97, 95% CI 1.42-2.72, P < 0.001). Additionally, adding SHR to the base model of traditional risk factors led to a significant improvement in the C-index, net reclassification and integrated discrimination.
conclusionsSHR was a significant predictor for adverse CV outcomes in CTVD patients with or without diabetes, which suggested that it could aid in the risk stratification in this particular population regardless of glucose metabolism status.
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