Impact of glucometabolic status on type 4a myocardial infarction in patients with non–ST-segment elevation myocardial infarction: the role of stress hyperglycemia ratio
Authors' conclusion
SHR emerged as a strong predictor of type 4a MI in NSTEMI patients undergoing PCI, outperforming other glucometabolic markers.
Study context
- Population
- Consecutive NSTEMI patients undergoing percutaneous coronary intervention (PCI) with stable or falling pre-procedural cardiac troponin, AMIPE registry; mean age 70.3 ± 12.5 years, 25.5% females, 45.9% DM
- Participants
- 1,005 patients
- Exposure
- Stress hyperglycemia ratio (SHR) vs ABG vs HbA1c for predicting type 4a myocardial infarction (MI)
- Outcome
- Type 4a MI
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
Accuracy in predicting type 4a MI
| Group | AUC | Optimal cut-off |
|---|---|---|
| SHR | 0.69 (95% CI 0.65-0.73) | 1.14 |
SHR
AUC0.69 (95% CI 0.65-0.73)
Optimal cut-off1.14
- SHR vs ABG and HbA1c: P < 0.001 — significantly higher accuracy with SHR
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| SHR > 1.14 and type 4a MISHR > 1.14vs SHR ≤1.14Independent association, unlike ABG and HbA1c | 2.73 (1.70–4.42) | P < 0.001 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Long-term MACE
- SHR > 1.14 linked to increased risk of long-term MACE
- P < 0.001
Original publication
Impact of glucometabolic status on type 4a myocardial infarction in patients with non–ST-segment elevation myocardial infarction: the role of stress hyperglycemia ratio. Cardiovasc Diabetol. Published 11 October 2025. doi:10.
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