Stress Hyperglycemia Ratio Predicts MACE and All-cause Mortality in Acute Coronary Syndrome Patients: A Meta-Analysis Comparing Patient with Diabetes Mellitus and Non-Diabetes Mellitus AHA Conference Repository

American Heart Association

174

Final ID: MDP577

Stress Hyperglycemia Ratio Predicts MACE and All-cause Mortality in Acute Coronary Syndrome Patients: A Meta-Analysis Comparing Patient with Diabetes Mellitus and Non-Diabetes Mellitus

Abstract Body (Do not enter title and authors here): Background: A higher stress hyperglycemic ratio (SHR) has been reported to be associated with adverse cardiac outcomes. However, the role of SHR in predicting clinical outcomes by comparing patients with and without diabetes mellitus is yet to be explored.

Objective: To evaluate the prognostic value of the SHR for predicting major adverse cardiovascular (MACE) and all-cause mortality in ACS patients with and without diabetes mellitus.

Methods: Per PRISMA guidelines, we comprehensively reviewed PubMed, Google Scholar, and SCOPUS for eligible studies reporting on SHR and its association with MACE (8 studies) and all-cause mortality (7 studies) in ACS patients. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a binary random-effects model, with results displayed as forest plots. Heterogeneity was assessed using I2 statistics, and a leave-one-out sensitivity analysis was performed. P<0.05 was considered significant.

Results: A total of 15 studies with 45,774 patients with ACS were included in the analysis. The majority of patients were males (72.6%) with a mean age of 62.8 years. High SHR was associated with higher odds of MACE (1.93 [1.54–2.42]) and all-cause mortality (1.91 [1.58–2.31]) (Fig. 1). Subgroup analysis revealed increased odds of all-cause mortality (1.69 [1.34–2.11] for patients with diabetes vs 2.12 [1.65–2.71] for patients without diabetes) and MACE (1.60 [1.30–1.97] for patients with diabetes vs 1.44 [1.28–1.62] for patients without diabetes), all p<0.01. (Fig. 2). Additionally, the leave-one-out sensitivity analysis demonstrated that excluding any particular study did not significantly affect outcomes (p<0.05).

Conclusions: In patients with ACS, SHR is an independent predictor of MACE and all-cause mortality, irrespective of diabetes status. Strict glycemic control strategies may improve outcomes in this high-risk population. These findings underscore the importance of early recognition and management of stress hyperglycemia in ACS patients.

Kanagala, Ramya S D ( Mamata Medical College , Khammam , Telangana , India )
Kanthala, Neha ( Kamineni Academy of Medical Sciences and Research Centre , Hyderabad , India )
Mathew, Joanne ( Central Michigan University , Saginaw , Michigan , United States )
Mylavarapu, Maneeth ( Adelphi University , Garden City , New York , United States )
Singh, Sachin ( Central Michigan University , Saginaw , Michigan , United States )
Vala, Lovekumar ( Shantabaa Medical College and General Hospital , Amreli , India )
Dhadhal, Riya ( Surat Municipal Institute of Medical Education and Research , Surat , India )
Danish, Ali ( Southwest Healthcare Medical Education Consortium , Temecula , California , United States )
Damarlapally, Nanush ( Independant Researcher , Houston , Texas , United States )
Mohammed, Adil ( Central Michigan University , Saginaw , Michigan , United States )
Ahmed, Hafeezuddin ( Corewell Health William Beaumont Royal Oak Hospital , Royal Oak , Michigan , United States )
Alsulami, Meshal ( Central Michigan University , Saginaw , Michigan , United States )
Desai, Rupak ( Independent Researcher , Atlanta , Georgia , United States )

Author Disclosures:

Ramya S D Kanagala: