Association of stress hyperglycemia with clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention: a cohort study
Authors' conclusion
Stress hyperglycemia was significantly associated with an increased risk of in-hospital death and all-cause mortality in STEMI patients treated with PCI. Stress hyperglycemia should be considered a high-risk prognostic marker in all STEMI patients, regardless of with or without diabetes.
Study context
- Population
- Patients with ST-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI), 2016–2021
- Participants
- 1,099 patients
- Exposure
- Markers of stress hyperglycaemia
- Outcome
- In-hospital death and all-cause mortality
Main finding
As reported in the abstract
- In-hospital death, admission blood glucose (ABG) OR
- 1.27 (95% CI 1.19-1.36)
- In-hospital death, fasting blood sugar (FBS) OR
- 1.25 (95% CI 1.16-1.35)
- In-hospital death, SHR1 OR
- 1.61 (95% CI 1.21-2.14)
- In-hospital death, SHR2 OR
- 1.57 (95% CI 1.22-2.01)
- In-hospital death, SHR3 OR
- 1.59 (95% CI 1.24-2.05)
- All-cause mortality, ABG HR
- 1.10 (95% CI 1.07-1.14)
- All-cause mortality, FBS HR
- 1.12 (95 CI 1.07-1.17)
- All-cause mortality, SHR1 HR
- 1.19 (95% CI 1.03-1.39)
- All-cause mortality, SHR2 HR
- 1.28 (95% CI 1.14-1.44)
- All-cause mortality, SHR3 HR
- 1.29 (95% CI 1.14-1.45)
Observational data: associations, not effects.
Further findings
Shape of association
- Inflection point for stress hyperglycemia ratio (SHR)
- 1.2
- Non-linear, J-shaped; risk significantly increased when ABG and FBS exceeded 5mmol/L
Original publication
Association of stress hyperglycemia with clinical outcomes in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention: a cohort study. Cardiovasc Diabetol. Published 12 April 2023. doi:10.
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