Association of stress hyperglycemia ratio with short-term and long-term prognosis in patients undergoing coronary artery bypass grafting across different glucose metabolism states: a large-scale cohort study

• DOI: 10.1186/s12933-025-02682-z
• Publication Date: 2025-04-24T15:39:49Z
• Authors: Zhongchen Li; Runze Chen; Zhiwei Zeng; Peng Wang; Chunyu Yu; Shuo Yuan; Xiaoting Su; Yan Zhao; Heng Zhang; Zhe Zheng
• Keywords: Angiology; Carbohydrate Metabolism

Stress hyperglycemia ratio (SHR) is recognized as a reliable indicator of acute during stress. Patients undergoing coronary artery bypass grafting (CABG) are at high risk stress hyperglycemia, but little attention has been paid to this population. This study the first investigate association between SHR and both short-term long-term prognosis in CABG patients, with further exploration impact across different glucose metabolic states. A total 18,307 patients isolated were consecutively enrolled categorized into three groups based on tertiles. The perioperative outcome was defined composite in-hospital death, myocardial infarction, cerebrovascular accident, reoperation hospitalization. major adverse cardiovascular events (MACCEs). Restricted cubic spline logistic regression linked risks. Kaplan-Meier Cox analyses used determine relationship prognosis. Subgroup conducted U-shaped observed overall population (P for nonlinear < 0.001). As increased, initially decreased (OR per SD: 0.87, 95% CI 0.79-0.97, P = 0.013) then elevated 1.16, 1.04-1.28, 0.004), an inflection point 0.79. similar pattern identified normal regulation. Among those prediabetes, J-shaped, while diabetes, became nonsignificant when exceeded 0.76. Adding existing model improved predictive performance outcomes (AUC: 0.720 → 0.752, 0.001; NRI: 0.036, 0.003; IDI: 0.015, For outcomes, monotonically increasing SHR, regardless status. third tertile showed 10.7% greater MACCEs (HR: 1.107, 1.023-1.231, 0.024). significantly associated demonstrating non-linear linear positive outcomes. attenuated diabetes. WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: common period short- novel metric that accounts baseline glycemia better reflect stress-induced hyperglycemia. However, not studied THE KEY RESEARCH QUESTION?: CABG, exploring its states, regulation, NEW?: In shows which modulated by HOW MIGHT STUDYINFLUENCE CLINICAL PRACTICE?: Findings support incorporation stratification personalized management ultimately improving