PD414 - PROGNOSTIC SIGNIFICANCE OF STRESS HYPERGLYCEMIA RATIO IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

PD414

PROGNOSTIC SIGNIFICANCE OF STRESS HYPERGLYCEMIA RATIO IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Y. Cheng^1,*

¹The People’s Hospital of Hechuan Chongqing, Chongqing, China

Rationale: The stress hyperglycemia ratio (SHR), an indicator of acute glycemic variability, predicts outcomes better than admission glucose in patients with or without diabetes. This study evaluated the association between SHR and major adverse cardiovascular events (MACE) in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI).

Methods: We conducted a single-center retrospective analysis of 394 consecutive AMI patients treated at one hospital between May 2020 and December 2024. SHR was calculated as: fasting plasma glucose (mmol/L) / [(1.59 × HbA1c (%)) - 2.59]. The primary endpoint was in-hospital MACE, a composite of cardiovascular mortality, recurrent AMI, and stroke. Multivariable logistic regression and receiver-operating characteristic (ROC) curve analyses were performed.

Results: Among 394 patients (239 men, 155 women; mean age 67±8 years), 58 (14.7%) developed in-hospital MACE. MACE incidence increased across SHR tertiles: 9, 16, and 33 events in low, medium, and high groups, respectively. After adjusting for age, sex, diabetes, and Killip class, the high SHR tertile independently predicted MACE (adjusted odds ratio 2.87, 95% CI 2.42-3.10) compared to the low tertile. This association remained consistent regardless of diabetes status (P for interaction = 0.76). The area under the ROC curve for SHR alone in predicting MACE was 0.69 (95% CI 0.65-0.73), increasing to 0.78 (95% CI 0.74-0.83) when combined with clinical parameters.

Conclusion: SHR is a strong independent predictor of short-term MACE in AMI patients undergoing PCI. Incorporating SHR into routine clinical risk assessment significantly enhances MACE prediction, supporting its value for early risk stratification.

Disclosure of Interest: None declared