Related Experiment Video
Updated: May 8, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Association between stress hyperglycemia ratio and in-hospital mortality in acute myocardial infarction: a
Wei Wang1, Qing Li1, Lingling Shu1
1Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe road 600, Tianhe district, GuangZhou, Guangdong Province, 510630, China.
Background:
Stress hyperglycemia ratio (SHR) represents the degree of acute glycemic stress relative to chronic glycemic control. Although SHR has been proposed as a better prognostic marker than absolute glucose levels, its quantitative relationship with in-hospital mortality in acute myocardial infarction (AMI) remains uncertain.
Methods:
A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to August 10, 2025. Observational studies reporting the association between SHR and in-hospital mortality in AMI were included. Quality assessment was performed using the Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random-effects model. The dose-response relationships were analyzed using the Greenland and Longnecker method and restricted cubic spline models.
Results:
Eleven studies involving 27,343 patients were included. Higher SHR was significantly associated with increased in-hospital mortality (pooled OR = 2.14; 95% CI: 1.74-2.55; I² = 63%; P < 0.001). The association remained basically consistent across subgroups and sensitivity analysis. Furthermore, the restricted cubic spline model illustrated a non-linear dose-response association between SHR and in-hospital mortality.
Conclusions:
In patients with AMI, an elevated SHR is consistently and non-linearly associated with a higher risk of in-hospital mortality. These findings suggest that SHR may serve as a valuable prognostic tool for early risk stratification, although further prospective studies are needed to confirm its clinical utility.
Related Concept Videos
Hyperglycemia
Hypoglycemia and Glucagon
Psychoneuroimmunology: Diabetes and Cancer
Hypoglycemia
Overview of Carbohydrate Metabolism
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
Coronary Artery Disease I: Introduction
