The impact of fasting stress hyperglycemia ratio, fasting plasma glucose and hemoglobin A1c on in-hospital mortality in patients with and without diabetes: findings from the China acute myocardial infarction registry
Authors' conclusion
This study indicated that, in individuals with AMI, fasting SHR as well as FPG was strongly associated with in-hospital mortality regardless of glucose metabolism status. Fasting SHR and FPG might be considered as a useful marker for risk stratification in this population.
Study context
- Population
- Acute myocardial infarction (AMI) patients with or without diabetes, China Acute Myocardial Infarction (CAMI) registry; 2081 with diabetes, 3227 without
- Participants
- 5,308 patients
- Exposure
- Quartiles of fasting stress hyperglycemia ratio (SHR), FPG and HbA1c (Q4 vs Q1), in patients with and without diabetes
- Outcome
- In-hospital mortality
Methodological detailsnationwide, multicenter
- Nationwide
- Multicenter
Main finding
As reported in the abstract
In-hospital mortality by fasting SHR quartile
Quartile 4 vs Quartile 1Adjusted odds ratio (95% CI)
Diabetic cohort; 9.7% vs 2.0%
4.070(2.014–8.228)
Nondiabetic cohort; 8.8% vs 2.2%
2.976(1.695–5.224)
- Overall in-hospital deaths
- 225 (4.2%)
Observational data: associations, not effects.
Further findings
FPG and in-hospital mortality
- Similar results for FPG as continuous or categorical variable
Predictive value for in-hospital mortality (AUC)
- Diabetes: AUC fasting SHR
- 0.702
- Diabetes: AUC FPG
- 0.689
- No diabetes: AUC fasting SHR
- 0.690
- No diabetes: AUC FPG
- 0.693
- HbA1c did not have moderate predictive value; AUC of fasting SHR not significantly different from FPG
- Adding fasting SHR or FPG to original model significantly improved C-statistic regardless of diabetic status
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The impact of fasting stress hyperglycemia ratio, fasting plasma glucose and hemoglobin A1c on in-hospital mortality in patients with and without diabetes: findings from the China acute myocardial infarction registry. Cardiovasc Diabetol. Published 4 July 2023. doi:10.
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