Impact of stress hyperglycemia ratio on mortality in patients with critical acute myocardial infarction: insight from american MIMIC-IV and the chinese CIN-II study

Cardiovascular Diabetology

Research

Fei Gao¹  Ning Tan²  Yong Liu²  Haozhang Huang²  Jin Liu²  Yang Zhou²  Chenyang Wang²  Yu Kang²  Nianjin Xie²  Yuqi Li³  Jielan Wu⁴  Tingting Zhu⁵  Shiqun Chen⁶  Xueyan Zheng⁷  Ruilin Meng⁷  Yuwei Gao⁸  Rui Liu⁹ 

[1] Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China;Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China;Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;Department of Cardiology, Zhongshan City People’s Hospital, Zhongshan, China;Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China;Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China;The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China;Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK;Global Health Research Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Guangzhou, China;Institute of Control and Prevention for Chronic Non-infective Disease, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China;Jinan university, Zhuhai People’s Hospital, Zhuhai, China;School of Mathematics, South China University of Technology, Guangzhou, China;

关键词: Coronary artery disease;    Stress hyperglycemia ratio;    Diabetes;    Mortality;   

DOI  :  10.1186/s12933-023-02012-1

 received in 2023-08-01, accepted in 2023-10-04,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAmong patients with acute coronary syndrome and percutaneous coronary intervention, stress hyperglycemia ratio (SHR) is primarily associated with short-term unfavorable outcomes. However, the relationship between SHR and long-term worsen prognosis in acute myocardial infarction (AMI) patients admitted in intensive care unit (ICU) are not fully investigated, especially in those with different ethnicity. This study aimed to clarify the association of SHR with all-cause mortality in critical AMI patients from American and Chinese cohorts.MethodsOverall 4,337 AMI patients with their first ICU admission from the American Medical Information Mart for Intensive Care (MIMIC)-IV database (n = 2,166) and Chinese multicenter registry cohort Cardiorenal ImprovemeNt II (CIN-II, n = 2,171) were included in this study. The patients were divided into 4 groups based on quantiles of SHR in both two cohorts.ResultsThe total mortality was 23.8% (maximum follow-up time: 12.1 years) in American MIMIC-IV and 29.1% (maximum follow-up time: 14.1 years) in Chinese CIN-II. In MIMIC-IV cohort, patients with SHR of quartile 4 had higher risk of 1-year (adjusted hazard radio [aHR] = 1.87; 95% CI: 1.40–2.50) and long-term (aHR = 1.63; 95% CI: 1.27–2.09) all-cause mortality than quartile 2 (as reference). Similar results were observed in CIN-II cohort (1-year mortality: aHR = 1.44; 95%CI: 1.03–2.02; long-term mortality: aHR = 1.32; 95%CI: 1.05–1.66). In both two group, restricted cubic splines indicated a J-shaped correlation between SHR and all-cause mortality. In subgroup analysis, SHR was significantly associated with higher 1-year and long-term all-cause mortality among patients without diabetes in both MIMIC-IV and CIN-II cohort.ConclusionAmong critical AMI patients, elevated SHR is significantly associated with and 1-year and long-term all-cause mortality, especially in those without diabetes, and the results are consistently in both American and Chinese cohorts.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 7