Simultaneous assessment of stress hyperglycemia ratio and glycemic variability to predict mortality in patients with coronary artery disease: a retrospective cohort study from the MIMIC-IV database
Authors' conclusion
The simultaneous evaluation of SHR and GV provides more information for risk stratification and prognostic prediction than SHR and GV alone, contributing to developing individualized strategies for glucose management in patients with CAD admitted to the ICU.
Study context
- Population
- Patients with coronary artery disease (CAD) hospitalized in the intensive care unit (ICU), MIMIC-IV database (version 2.2), 2008–2019; mean age 69.6 years, 30.1% female
- Participants
- 2,789 patients
- Exposure
- Combined stress hyperglycemia ratio (SHR) and glycemic variability (GV) vs SHR or GV alone for predicting mortality
- Outcome
- 1-year mortality
- Follow-up
- 1 year
Methodological detailsMIMIC-IV database
- MIMIC-IV database
Main finding
As reported in the abstract
1-year mortality: discrimination (ROC analysis)
- Deaths at 1 year
- 404 (14.5%)
- SHR + GV vs SHR alone (ROC)
- 0.644 vs. 0.615, p = 0.007
- SHR + GV vs GV alone (ROC)
- 0.644 vs. 0.603, p < 0.001
- Nondiabetic, high SHR and high GV: greatest risk of 1-year mortality, HR
- 5.830 (3.175-10.702) (95% CI)
- Diabetic, high SHR but low GV: highest risk of 1-year mortality, HR
- 2.013 (1.224-3.311) (95% CI)
Observational data: associations, not effects.
Secondary outcomes
In-hospital mortality
- Deaths in hospital
- 138 (4.9%)
- SHR + GV vs SHR alone (ROC)
- 0.710 vs. 0.689, p = 0.012
- SHR + GV vs GV alone (ROC)
- 0.710 vs. 0.632, p = 0.004
- Nondiabetic, high SHR and high GV: greatest risk, OR
- 10.831 (4.494-26.105) (95% CI)
- Diabetic, high SHR but low GV: highest risk, OR
- 4.221 (1.542-11.558) (95% CI)
Original publication
Simultaneous assessment of stress hyperglycemia ratio and glycemic variability to predict mortality in patients with coronary artery disease: a retrospective cohort study from the MIMIC-IV database. Cardiovasc Diabetol. Published 9 February 2024. doi:10.
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