Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study
Abstract Background The stress hyperglycaemic ratio (SHR), a new marker that reflects the true hyperglycaemic state of patients with acute coronary syndrome (ACS), is strongly associated with adverse clinical outcomes in these patients. Studies on the relationship between the SHR and in-hospital car...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-02-01
|
| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-024-02128-y |
| _version_ | 1797275959697604608 |
|---|---|
| author | Kui Li Xueyuan Yang Yunhang Li Guanxue Xu Yi Ma |
| author_facet | Kui Li Xueyuan Yang Yunhang Li Guanxue Xu Yi Ma |
| author_sort | Kui Li |
| collection | DOAJ |
| description | Abstract Background The stress hyperglycaemic ratio (SHR), a new marker that reflects the true hyperglycaemic state of patients with acute coronary syndrome (ACS), is strongly associated with adverse clinical outcomes in these patients. Studies on the relationship between the SHR and in-hospital cardiac arrest (IHCA) incidence are limited. This study elucidated the relationship between the SHR and incidence of IHCA in patients with ACS. Methods In total, 1,939 patients with ACS who underwent percutaneous coronary intervention (PCI) at the Affiliated Hospital of Zunyi Medical University were included. They were divided into three groups according to the SHR: group T1 (SHR ≤ 0.838, N = 646), group T2 (0.838< SHR ≤ 1.140, N = 646), and group T3 (SHR3 > 1.140, N = 647). The primary endpoint was IHCA incidence. Results The overall IHCA incidence was 4.1% (N = 80). After adjusting for covariates, SHR was significantly associated with IHCA incidence in patients with ACS who underwent PCI (odds ratio [OR] = 2.6800; 95% confidence interval [CI] = 1.6200–4.4300; p<0.001), and compared with the T1 group, the T3 group had an increased IHCA risk (OR = 2.1800; 95% CI = 1.2100–3.9300; p = 0.0090). In subgroup analyses, after adjusting for covariates, patients with ST-segment elevation myocardial infarction (STEMI) (OR = 3.0700; 95% CI = 1.4100–6.6600; p = 0.0050) and non-STEMI (NSTEMI) (OR = 2.9900; 95% CI = 1.1000–8.1100; p = 0.0310) were at an increased IHCA risk. After adjusting for covariates, IHCA risk was higher in patients with diabetes mellitus (DM) (OR = 2.5900; 95% CI = 1.4200–4.7300; p = 0.0020) and those without DM (non-DM) (OR = 3.3000; 95% CI = 1.2700–8.5800; p = 0.0140); patients with DM in the T3 group had an increased IHCA risk compared with those in the T1 group (OR = 2.4200; 95% CI = 1.0800–5.4300; p = 0.0320). The restriction cubic spline (RCS) analyses revealed a dose-response relationship between IHCA incidence and SHR, with an increased IHCA risk when SHR was higher than 1.773. Adding SHR to the baseline risk model improved the predictive value of IHCA in patients with ACS treated with PCI (net reclassification improvement [NRI]: 0.0734 [0.0058–0.1409], p = 0.0332; integrated discrimination improvement [IDI]: 0.0218 [0.0063–0.0374], p = 0.0060). Conclusions In patients with ACS treated with PCI, the SHR was significantly associated with the incidence of IHCA. The SHR may be a useful predictor of the incidence of IHCA in patients with ACS. The addition of the SHR to the baseline risk model had an incremental effect on the predictive value of IHCA in patients with ACS treated with PCI. |
| first_indexed | 2024-03-07T15:21:30Z |
| format | Article |
| id | doaj.art-00826bcdb9994d56b1f82a699c018ee5 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-07T15:21:30Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-00826bcdb9994d56b1f82a699c018ee52024-03-05T17:36:26ZengBMCCardiovascular Diabetology1475-28402024-02-0123111210.1186/s12933-024-02128-yRelationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort studyKui Li0Xueyuan Yang1Yunhang Li2Guanxue Xu3Yi Ma4Department of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiovascular Medicine, Affiliated Hospital of Zunyi Medical UniversityAbstract Background The stress hyperglycaemic ratio (SHR), a new marker that reflects the true hyperglycaemic state of patients with acute coronary syndrome (ACS), is strongly associated with adverse clinical outcomes in these patients. Studies on the relationship between the SHR and in-hospital cardiac arrest (IHCA) incidence are limited. This study elucidated the relationship between the SHR and incidence of IHCA in patients with ACS. Methods In total, 1,939 patients with ACS who underwent percutaneous coronary intervention (PCI) at the Affiliated Hospital of Zunyi Medical University were included. They were divided into three groups according to the SHR: group T1 (SHR ≤ 0.838, N = 646), group T2 (0.838< SHR ≤ 1.140, N = 646), and group T3 (SHR3 > 1.140, N = 647). The primary endpoint was IHCA incidence. Results The overall IHCA incidence was 4.1% (N = 80). After adjusting for covariates, SHR was significantly associated with IHCA incidence in patients with ACS who underwent PCI (odds ratio [OR] = 2.6800; 95% confidence interval [CI] = 1.6200–4.4300; p<0.001), and compared with the T1 group, the T3 group had an increased IHCA risk (OR = 2.1800; 95% CI = 1.2100–3.9300; p = 0.0090). In subgroup analyses, after adjusting for covariates, patients with ST-segment elevation myocardial infarction (STEMI) (OR = 3.0700; 95% CI = 1.4100–6.6600; p = 0.0050) and non-STEMI (NSTEMI) (OR = 2.9900; 95% CI = 1.1000–8.1100; p = 0.0310) were at an increased IHCA risk. After adjusting for covariates, IHCA risk was higher in patients with diabetes mellitus (DM) (OR = 2.5900; 95% CI = 1.4200–4.7300; p = 0.0020) and those without DM (non-DM) (OR = 3.3000; 95% CI = 1.2700–8.5800; p = 0.0140); patients with DM in the T3 group had an increased IHCA risk compared with those in the T1 group (OR = 2.4200; 95% CI = 1.0800–5.4300; p = 0.0320). The restriction cubic spline (RCS) analyses revealed a dose-response relationship between IHCA incidence and SHR, with an increased IHCA risk when SHR was higher than 1.773. Adding SHR to the baseline risk model improved the predictive value of IHCA in patients with ACS treated with PCI (net reclassification improvement [NRI]: 0.0734 [0.0058–0.1409], p = 0.0332; integrated discrimination improvement [IDI]: 0.0218 [0.0063–0.0374], p = 0.0060). Conclusions In patients with ACS treated with PCI, the SHR was significantly associated with the incidence of IHCA. The SHR may be a useful predictor of the incidence of IHCA in patients with ACS. The addition of the SHR to the baseline risk model had an incremental effect on the predictive value of IHCA in patients with ACS treated with PCI.https://doi.org/10.1186/s12933-024-02128-yStress hyperglycaemic ratioIncidenceIn-hospital cardiac arrest patientsAcute coronary syndromeRetrospective cohort study |
| spellingShingle | Kui Li Xueyuan Yang Yunhang Li Guanxue Xu Yi Ma Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study Cardiovascular Diabetology Stress hyperglycaemic ratio Incidence In-hospital cardiac arrest patients Acute coronary syndrome Retrospective cohort study |
| title | Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study |
| title_full | Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study |
| title_fullStr | Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study |
| title_full_unstemmed | Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study |
| title_short | Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study |
| title_sort | relationship between stress hyperglycaemic ratio and incidence of in hospital cardiac arrest in patients with acute coronary syndrome a retrospective cohort study |
| topic | Stress hyperglycaemic ratio Incidence In-hospital cardiac arrest patients Acute coronary syndrome Retrospective cohort study |
| url | https://doi.org/10.1186/s12933-024-02128-y |
| work_keys_str_mv | AT kuili relationshipbetweenstresshyperglycaemicratioandincidenceofinhospitalcardiacarrestinpatientswithacutecoronarysyndromearetrospectivecohortstudy AT xueyuanyang relationshipbetweenstresshyperglycaemicratioandincidenceofinhospitalcardiacarrestinpatientswithacutecoronarysyndromearetrospectivecohortstudy AT yunhangli relationshipbetweenstresshyperglycaemicratioandincidenceofinhospitalcardiacarrestinpatientswithacutecoronarysyndromearetrospectivecohortstudy AT guanxuexu relationshipbetweenstresshyperglycaemicratioandincidenceofinhospitalcardiacarrestinpatientswithacutecoronarysyndromearetrospectivecohortstudy AT yima relationshipbetweenstresshyperglycaemicratioandincidenceofinhospitalcardiacarrestinpatientswithacutecoronarysyndromearetrospectivecohortstudy |