Relative Hyperglycemia and In-Hospital Bleeding Across Glycemic Status in Patients on High-Intensity Antithrombotic...

Area of Science:

• Cardiology
• Endocrinology
• Clinical Research

Background:

• Relative hyperglycemia, indicated by the stress hyperglycemia ratio (SHR), is associated with adverse outcomes in acute coronary syndrome (ACS).
• The link between SHR and bleeding risk post-percutaneous coronary intervention (PCI) in patients with varying glycemic statuses is not well understood.

Purpose of the Study:

• To investigate the association between SHR and in-hospital major bleeding risk after PCI.
• To examine this association across different glycemic statuses (diabetes mellitus, pre-diabetes mellitus, normal glucose regulation).

Main Methods:

• Analysis of ACS patients undergoing PCI from the CCC-ACS registry and THMDP cohort.
• SHR calculated from admission fasting blood glucose and hemoglobin A1c.
• Primary outcome: in-hospital major bleeding.

Main Results:

• A high SHR (>1.0) was an independent predictor of major bleeding post-PCI in the total cohort (aOR 1.51).
• The highest bleeding risk associated with high SHR was observed in the pre-diabetes mellitus group (aOR 1.98).
• Findings were validated in an external cohort; guideline-directed medical therapy reduced bleeding risk.

Conclusions:

• Elevated SHR is an independent risk factor for in-hospital major bleeding after PCI, particularly in patients with pre-diabetes mellitus.
• Further research and clinical trials are warranted to explore SHR-targeted therapies for pre-diabetes mellitus patients.