Association between stress hyperglycemia ratio and in-hospi-tal outcomes:findings from the improving Care for Cardiovas-cular Disease in China-Acute Coronary Syndrome(CCC-ACS)ProjectOA

BACKGROUND Stress hyperglycemia ratio(SHR)could provide accurate information on the acute status of hyperglycemia.The relationship between SHR and acute coronary syndrome(ACS)prognosis remains unclear.This study was conducted to id-entity the association between SHR and in-hospital outcomes in patients with ACS. METHODS A total of 12,010 patients were eventually enrolled in the study.The relationship between SHR and in-hospital ma-jor adverse cardiovascular events(MACEs)was then modeled by restricted cubic spline(RCS)curves,and all patients were divi-ded into three groups according to the results.The multivariate logistic regression analysis was used to determine the associati-ons between the SHR and in-hospital outcomes,described as odds ratios(ORs)and 95％confidence intervals(CIs).Subgroup analy-ses were also performed on different diseases. RESULTS The median age of this cohort was 63(54,71)years old,and 8942(74.5％)were male.Group 1 was defined as SHR＜0.6(n=426),Group 2 was defined as SHR between 0.6 and 1(n=5821),and Group 3 was defined as SHR＞1(n=5763).Compared wi-th Group 2,Group 1(OR=1.891,95％CI:1.028-3.479,P＜0.001)and Group 3(OR=1.868,95％CI:1.434-2.434,P＜0.001)had higher risks of suffering from in-hospital MACEs.SHR was associated with higher risks of in-hospital MACEs in the subgroups of DM[OR=2.282,95％CI:1.477-3.524). CONCLUSIONS Both low and high SHR levels were independently associated with in-hospital MACEs.Young males with DM,hypertension,and decreased renal function had much higher risks of suffering from SHR-correlated MACEs.