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Background <p>Stress hyperglycemia ratio (SHR) has been associated with adverse clinical outcomes in hospitalized patients with acute coronary syndromes (ACS). However, its role in long-term prognosis remains controversial. This study aims to investigate the correlation between SHR and post-discharge all-cause mortality in coronary heart disease (CHD) patients.</p> Methods <p>A retrospective cohort analysis was conducted on a comprehensive dataset encompassing 5,273 coronary heart disease (CHD) patients from The First Affiliated Hospital of Shantou University Medical College, spanning from January 2020 to April 2024. The study introduced a novel parameter, Stress hyperglycemia ratio (SHR), calculated using the formula: SHR =<InlineEquation ID="IEq1"> <EquationSource Format="TEX">\(\:\frac{\text{A}\text{d}\text{m}\text{i}\text{s}\text{s}\text{i}\text{o}\text{n}\:\text{B}\text{l}\text{o}\text{o}\text{d}\:\text{G}\text{l}\text{u}\text{c}\text{o}\text{s}\text{e}(\text{m}\text{m}\text{o}\text{l}/\text{L})}{1.59\:\times\:\:\text{H}\text{b}\text{A}1\text{c}\left(\%\right)\:-\:2.59}\)</EquationSource> </InlineEquation>. Cox regression analysis, smooth curve fitting techniques, and subgroup analyses were employed to evaluate associations.</p> Results <p>During a maximum follow-up of 1,649 days, 8.1% of patients experienced all-cause mortality. After multivariable adjustments, a U-shaped association emerged between SHR and mortality risk (HR = 1.35, 95%CI= (1.03 ~ 1.77), <i>P</i> = 0.031). Both low and high SHR levels were linked to increased mortality.</p> Conclusions <p>SHR demonstrates a U-shaped association with post-discharge all-cause mortality in CHD patients, highlighting the need for glycemic management within an optimal range.</p>

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Association between stress hyperglycemia ratio and all-cause mortality in patients with coronary heart disease

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  • 发表日期：

    2025年12月16日

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  • Hailin Liang,
  • Chujuan Zeng,
  • Junhong Huang,
  • Yongluan Lin,
  • Songming Chen

摘要

Background

Stress hyperglycemia ratio (SHR) has been associated with adverse clinical outcomes in hospitalized patients with acute coronary syndromes (ACS). However, its role in long-term prognosis remains controversial. This study aims to investigate the correlation between SHR and post-discharge all-cause mortality in coronary heart disease (CHD) patients.

Methods

A retrospective cohort analysis was conducted on a comprehensive dataset encompassing 5,273 coronary heart disease (CHD) patients from The First Affiliated Hospital of Shantou University Medical College, spanning from January 2020 to April 2024. The study introduced a novel parameter, Stress hyperglycemia ratio (SHR), calculated using the formula: SHR = \(\:\frac{\text{A}\text{d}\text{m}\text{i}\text{s}\text{s}\text{i}\text{o}\text{n}\:\text{B}\text{l}\text{o}\text{o}\text{d}\:\text{G}\text{l}\text{u}\text{c}\text{o}\text{s}\text{e}(\text{m}\text{m}\text{o}\text{l}/\text{L})}{1.59\:\times\:\:\text{H}\text{b}\text{A}1\text{c}\left(\%\right)\:-\:2.59}\) . Cox regression analysis, smooth curve fitting techniques, and subgroup analyses were employed to evaluate associations.

Results

During a maximum follow-up of 1,649 days, 8.1% of patients experienced all-cause mortality. After multivariable adjustments, a U-shaped association emerged between SHR and mortality risk (HR = 1.35, 95%CI= (1.03 ~ 1.77), P = 0.031). Both low and high SHR levels were linked to increased mortality.

Conclusions

SHR demonstrates a U-shaped association with post-discharge all-cause mortality in CHD patients, highlighting the need for glycemic management within an optimal range.