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Schmitz, T.* ; Freuer, D.* ; Harmel, E.* ; Heier, M. ; Peters, A. ; Linseisen, J. ; Meisinger, C.*

Prognostic value of stress hyperglycemia ratio on short- and long-term mortality after acute myocardial infarction.

Acta Diabetol. 59, 1019-1029 (2022)

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Aims: Prior studies demonstrated an association between hospital admission blood glucose and mortality in acute myocardial infarction (AMI). Because stress hyperglycemia ratio (SHR) has been suggested as a more reliable marker of stress hyperglycemia this study investigated to what extent SHR in comparison with admission blood glucose is associated with short- and long-term mortality in diabetic and non-diabetic AMI patients. Methods: The analysis was based on 2,311 AMI patients aged 25–84 years from the population-based Myocardial Infarction Registry Augsburg (median follow-up time 6.5 years [IQR: 4.9–8.1]). The SHR was calculated as admission glucose (mg/dl)/(28.7 × HbA1c (%)—46.7). Using logistic and COX regression analyses the associations between SHR and admission glucose and mortality were investigated. Result: Higher admission glucose and higher SHR were significantly and nonlinearly associated with higher 28-day mortality in AMI patients with and without diabetes. In patients without diabetes, the AUC for SHR was significantly lower than for admission glucose (SHR: 0.6912 [95%CI 0.6317–0.7496], admission glucose: 0.716 [95%CI 0.6572–0.7736], p-value: 0.0351). In patients with diabetes the AUCs were similar for SHR and admission glucose. Increasing admission glucose and SHR were significantly nonlinearly associated with higher 5-year all-cause mortality in AMI patients with diabetes but not in non-diabetic patients. AUC values indicated a comparable prediction of 5-year mortality for both measures in diabetic and non-diabetic patients. Conclusions: Stress hyperglycemia in AMI patients plays a significant role mainly with regard to short-term prognosis, but barely so for long-term prognosis, underlining the assumption that it is a transient dynamic disorder that occurs to varying degrees during the acute event, thereby affecting prognosis.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Admission Glucose ; Long-term Mortality ; Myocardial Infarction ; Short-term Mortality ; Stress Hyperglycemia

ISSN (print) / ISBN 0940-5429

e-ISSN 1432-5233

Journal Acta Diabetologica

Quellenangaben Volume: 59, Issue: 8, Pages: 1019-1029

Publisher Springer

Publishing Place Milan

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Epidemiology II (EPI2)
Independent Research Group Clinical Epidemiology (KEPI)

Grants Faculty of Medicine, University of Augsburg
German Federal Ministry of Health
State of Bavaria
German Research Center for Environmental Health - German Federal Ministry of Education, Science, Research and Technology
Helmholtz Association