Fasting stress hyperglycemia ratio and in-hospital mortality after acute myocardial infarction in patients with different glucose metabolism status: Results from China acute myocardial infarction registry

Fu, R; Cui, K; Yang, J; Xu, H; Yin, D; Song, W; Wang, H; Zhu, C; Feng, L; Wang, Z; Wang, Q; Lu, Y; Dou, K; Yang, Y; CAMI Registry Investigators

doi:10.1016/j.diabres.2023.110241

Type 2 & other diabetes

Fasting stress hyperglycemia ratio and in-hospital mortality after acute myocardial infarction in patients with different glucose metabolism status: Results from China acute myocardial infarction registry

Diabetes Res Clin PractPublished 6 Jan 2023Prospective registry cohort study

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Authors' conclusion

This study firstly demonstrated a strong positive association between fasting SHR and in-hospital mortality in AMI patients with and without diabetes. Fasting SHR should be considered as a useful marker for risk stratification in AMI patients regardless of glucose metabolism status.

Study context

Population: Patients with acute myocardial infarction (AMI) from the China Acute Myocardial Infarction (CAMI) registry, 2,081 with diabetes; fasting stress hyperglycemia ratio (SHR) = FPG/(1.59 × HbA1c (%)-2.59)2,081 with diabetes
Participants: 5,308 patients

Exposure: High vs low fasting SHR, in patients with and without diabetes
Outcome: In-hospital mortality
Follow-up: In-hospital

Methodological detailsnationwide, multicenter

Nationwide
Multicenter

Main finding

As reported in the abstract

In-hospital mortality, patients with diabetes

High fasting SHR7.9%

Low fasting SHR2.2%

Each group vs low fasting SHREstimate (95% CI)

High fasting SHR

aOR 3.159(1.932–5.165)

High fasting SHR

OR IPTW 3.311(2.326–4.713)

Observational data: associations, not effects.

Further findings

Outcome	High fasting SHR	Low fasting SHR	← Lower odds with high fasting SHR ←→ Higher odds with high fasting SHR →	Estimate
In-hospital mortality, patients without diabetes	10.1%	2.5%	0.20.5125	aOR 3.189 (95% CI 2.161–4.705)
In-hospital mortality, patients without diabetes			0.20.5125	OR IPTW 3.224 (95% CI 2.465–4.217)
			0.20.5125Ratio (log scale)

In-hospital mortality, patients without diabetes: Optimal SHR cutoff 1.26 without diabetes

Prognostic power and incremental value of fasting SHR

Prognostic powers of fasting SHR for in-hospital mortality similar across glucose metabolism status
Adding fasting SHR to original model significantly improved C-statistic, net reclassification and integrated discrimination regardless of diabetes status

Original publication

Fasting stress hyperglycemia ratio and in-hospital mortality after acute myocardial infarction in patients with different glucose metabolism status: Results from China acute myocardial infarction registry. Diabetes Res Clin Pract. Published 6 January 2023. doi:10.1016/j.diabres.2023.110241

Read the original article ↗

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