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Stress Hyperglycemia Ratio as a Predictor of In-Hospital Stent Thrombosis in STEMI Patients Undergoing Primary PCI: A

Evliya Akdeniz1, Cennet Yıldız1, Mehmet Karaca2

  • 1Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34147 Istanbul, Turkey.

Medicina (Kaunas, Lithuania)
|July 30, 2025
PubMed

Insights

The stress hyperglycemia ratio (SHR) is a superior predictor of in-hospital stent thrombosis (ST) in ST-elevation myocardial infarction (STEMI) patients compared to admission hyperglycemia (AH). Managing stress hyperglycemia is crucial for STEMI outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Admission hyperglycemia (AH) is prevalent in ST-elevation myocardial infarction (STEMI) and associated with adverse outcomes.
  • The stress hyperglycemia ratio (SHR) may offer a more precise prognostic indicator than AH.
  • This study investigates the relationship between AH, SHR, and in-hospital stent thrombosis (ST) in STEMI patients.

Purpose of the Study:

  • To evaluate the predictive value of AH and SHR for in-hospital ST in STEMI patients undergoing primary percutaneous coronary intervention (p-PCI).
  • To identify independent predictors of ST in this patient cohort.

Main Methods:

  • A retrospective analysis of 1034 STEMI patients undergoing p-PCI.
  • AH defined as glucose ≥ 11.1 mmol/L; SHR calculated using admission glucose and HbA1c-derived estimated average glucose.
  • Logistic regression and ROC analysis were employed to identify ST predictors and optimal cutoffs.

Main Results:

  • In-hospital ST occurred in 1.5% of patients.
  • Patients with ST exhibited higher Killip class, heart rate, WBC, platelets, creatinine, AH, and SHR.
  • SHR (OR 3.15, p < 0.001) independently predicted ST, while AH did not (p = 0.182). An SHR cutoff of 1.26 predicted ST.

Conclusions:

  • SHR is a robust independent predictor of in-hospital ST post-STEMI, outperforming AH.
  • Effective management of stress-induced hyperglycemia is vital in STEMI care.
  • Further research is warranted to confirm these findings and explore therapeutic implications.

Keywords:
ST-elevation myocardial infarctionSTEMIprimary PCIstent thrombosisstress hyperglycemia ratio

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