The association between the stress hyperglycaemia ratio and mortality in cardiovascular disease: a meta-analysis and systematic review
Pooled result · All-cause mortality (short and longer term)Result — go to the resultRelative risk 1.67 95% CI 1.46–1.91Authors' conclusion
A raised SHR is associated with an increased risk of all-cause mortality following myocardial infarction and ischaemic stroke. Further work is required to define reference values for the SHR, and to investigate the potential effects of relative hypoglycaemia. Interventional trials targeting to the SHR rather than the absolute glucose value should be undertaken.
Study context
- Population
- Patients hospitalised for acute MI, ischaemic stroke or acute HF; searches of Medline, Embase, Cochrane CENTRAL and Web of Science to 1st March 2024
- Participants
- 80,010 patients32 studies
- Comparison
- Highest stress hyperglycaemia ratio (SHR) category vs lower SHR
- Outcome
- All-cause mortality
Methodological detailsrandom effects model, Newcastle Ottawa risk of bias assessment
- Random effects model
- Newcastle Ottawa risk of bias assessment
Pooled result
All-cause mortality (short and longer term)
Relative risk
1.67
95% CI 1.46–1.91
P < 0.001
As reported in the abstract
Further pooled results
All-cause mortality by cardiovascular presentation
- MI cohorts, RR
- 1.75 (1.52-2.01) (95% CI)
- Ischaemic stroke cohorts, RR
- 1.78 (1.26-2.50) (95% CI)
All-cause mortality by diabetes status
- Diabetes, RR
- 1.49 (1.14-1.94), p < 0.001 (95% CI)
- No diabetes, RR
- 1.85 (1.49-2.30), p < 0.001 (95% CI)
- P for subgroup differences
- P = 0.21
Mortality as single vs composite outcome
- Single outcome, RR
- 1.51 (1.29-1.77), p < 0.001 (95% CI)
- Composite outcome, RR
- 2.02 (1.58-2.59), p < 0.001 (95% CI)
All-cause mortality by length of follow-up
- 90 day, RR
- 1.84 (1.32-2.56), p < 0.001 (95% CI)
- 1 year, RR
- 1.69 (1.32-2.16), p < 0.001 (95% CI)
- > 1year, RR
- 1.58 (1.34-1.86), p < 0.001 (95% CI)
Original publication
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