Predictive value of the stress hyperglycemia ratio in dialysis patients with acute coronary syndrome: insights from a multi-center observational study
Main finding · MACEResult — go to the resultAdjusted hazard ratio 1.92 95% CI 1.48–2.49Authors' conclusion
In dialysis patients with ACS, SHR was independently associated with increased risks of MACE and mortality. Furthermore, SHR may aid in improving the predictive efficiency of the GRACE score, especially for those with diabetes. These results indicated that SHR might be a valuable tool for risk stratification and management of dialysis patients with ACS.
Study context
- Population
- Dialysis patients with acute coronary syndrome (ACS), January 2015 to June 2021, 30 tertiary medical centers in China
- Participants
- 714 patients
- Exposure
- Highest vs second stress hyperglycemia ratio (SHR) tertile
- Outcome
- MACE
- Follow-up
- Median 20.9 months
Methodological details30 tertiary medical centers in China
- 30 tertiary medical centers in China
Main finding
As reported in the abstract
Adjusted hazard ratio
1.92
95% CI 1.48–2.49
Highest SHR tertilevs Second SHR tertile
aHR 1.92 (95% CI 1.48–2.49)
- Major adverse cardiovascular events (MACE) events, overall
- 345 (48.3%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | |
|---|---|---|
| All-cause mortality · median follow-up 20.9 monthsMultivariable Cox regression | 2.19 (1.64–2.93) | |
| CV mortality · median follow-up 20.9 monthsMultivariable Cox regression | 2.70 (1.90–3.83) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- All-cause mortality — All-cause deaths, overall
- 280 (39.2%)
- CV mortality — CV deaths, overall
- 205
Diabetic and nondiabetic subgroups
- Similar association in both diabetic and nondiabetic patients
Adding SHR to Global Registry of Acute Coronary Events (GRACE) score
- Significantly improved predictive accuracy for MACE and mortality (C-statistic, NRI, IDI), especially with diabetes
Original publication
Predictive value of the stress hyperglycemia ratio in dialysis patients with acute coronary syndrome: insights from a multi-center observational study. Cardiovasc Diabetol. Published 27 October 2023. doi:10.
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