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Association between stress hyperglycemia ratio and all-cause mortality in patients with coronary heart disease

Hailin Liang1,2, Chujuan Zeng1, Junhong Huang1,2

  • 1Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College of Shantou City, No. 57 Changping Road, Shantou, Guangdong Province, 515000, China.

BMC Cardiovascular Disorders
|December 16, 2025
PubMed

Insights

The Stress Hyperglycemia Ratio (SHR) shows a U-shaped link with long-term mortality in coronary heart disease (CHD) patients. Both low and high SHR levels indicate increased risk, emphasizing optimal glycemic control.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • The Stress Hyperglycemia Ratio (SHR) is linked to poor outcomes in acute coronary syndromes (ACS).
  • Its long-term prognostic value in coronary heart disease (CHD) requires further investigation.
  • This study examines the association between SHR and post-discharge mortality in CHD patients.

Purpose of the Study:

  • To investigate the correlation between the Stress Hyperglycemia Ratio (SHR) and all-cause mortality after hospital discharge in patients with coronary heart disease (CHD).

Main Methods:

  • Retrospective cohort analysis of 5,273 CHD patients.
  • Utilized a novel parameter, the Stress Hyperglycemia Ratio (SHR).
  • Employed Cox regression, smooth curve fitting, and subgroup analyses.

Main Results:

  • A U-shaped association was observed between SHR and all-cause mortality (HR=1.35, P=0.031) after multivariable adjustments.
  • Both lower and higher levels of SHR were independently associated with increased mortality risk.
  • All-cause mortality occurred in 8.1% of patients during a median follow-up of 1,649 days.

Conclusions:

  • The Stress Hyperglycemia Ratio (SHR) exhibits a U-shaped relationship with post-discharge all-cause mortality in CHD patients.
  • Findings underscore the importance of maintaining glycemic control within an optimal range for improved patient outcomes.
  • SHR may serve as a valuable prognostic marker in CHD management.
Abstract

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