The impact of the stress hyperglycemia ratio on mortality and rehospitalization rate in patients with acute decompensated heart failure and diabetes
Authors' conclusion
Both elevated and reduced SHRs indicate an unfavorable long-term prognosis in patients with ADHF and diabetes.
Study context
- Population
- Acute decompensated heart failure (ADHF) patients with diabetes; Stress hyperglycemia ratio (SHR) = admission blood glucose/[(28.7 × HbA1c%) - 46.7]of 1904 ADHF enrolled
- Participants
- 780 patients
- Exposure
- SHR quintiles
- Outcome
- All-cause death
- Follow-up
- 3-year follow-up
Methodological detailsconsecutive enrolment, SHR quintiles
- Consecutive enrolment
- SHR quintiles
Main finding
As reported in the abstract
median follow-up 3.24 years
Hazard ratio (95% CI)
Q5vs Q2
2.76(1.63–4.68)
Q1vs Q2
2.33(1.35–4.02)
- All-cause deaths
- 169
- Lowest mortality in 2nd quintile (Kaplan-Meier)
- P = 0.0028
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death · 3-year follow-upQ5vs Q2 | 2.81 (1.66–4.75) | |
| CV death · 3-year follow-upQ1vs Q2 | 2.32 (1.35–4.00) | |
| HF rehospitalization · 3-year follow-upQ5vs Q2 | 1.54 (1.03–2.32) | |
| 0.20.5125Hazard ratio (log scale) |
Heart failure (HF) rehospitalization · 3-year follow-up
- U-shaped association between SHR and rehospitalization
Mortality by HF subtype (heart failure with preserved ejection fraction (HFpEF), heart failure with reduced ejection fraction (HFrEF))
- U-shaped association between SHR and mortality remained significant in both HFpEF and HFrEF
Original publication
The impact of the stress hyperglycemia ratio on mortality and rehospitalization rate in patients with acute decompensated heart failure and diabetes. Cardiovasc Diabetol. Published 26 July 2023. doi:10.
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