Related Experiment Video

Updated: Aug 19, 2026

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
09:35

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia

Published on: November 15, 2024

Association between stress hyperglycemia ratio and acute total occlusion in patients with non-ST-segment elevation

Shuai Wang1, Jiatong Li1, Shan Xie1

  • 1Department of Emergency, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.

Frontiers in Endocrinology
|August 18, 2026
PubMed

Insights

The stress hyperglycemia ratio (SHR) can help identify acute total occlusion (ATO) in non-ST-segment elevation myocardial infarction (NSTEMI) patients. Elevated admission SHR is independently linked to a higher likelihood of ATO, aiding in risk assessment.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Myocardial Infarction

Background:

  • Acute total occlusion (ATO) in non-ST-segment elevation myocardial infarction (NSTEMI) signifies a high-risk group, yet early identification is difficult.
  • The stress hyperglycemia ratio (SHR) quantifies acute glucose elevation against chronic glycemic status.

Purpose of the Study:

  • To investigate the association between admission SHR and ATO in NSTEMI patients.
  • To assess the discriminatory performance and independent association of SHR with ATO.

Main Methods:

  • Retrospective, single-center observational cohort study of 827 NSTEMI patients undergoing coronary angiography.
  • SHR calculated from fasting plasma glucose and glycated hemoglobin; ATO defined by Thrombolysis in Myocardial Infarction flow grade.
  • Statistical analyses included ROC, multivariable logistic regression, and restricted cubic spline analyses.

Main Results:

  • SHR demonstrated superior discriminatory performance for ATO (AUC, 0.743) compared to fasting plasma glucose or HbA1c.
  • An optimal SHR cutoff of 0.903 was identified.
  • Elevated SHR (>0.903) was independently associated with significantly higher odds of ATO (aOR, 5.09; P<0.001).

Conclusions:

  • Admission SHR is independently and nonlinearly associated with ATO in NSTEMI patients.
  • SHR may serve as a valuable adjunct to clinical assessment for identifying ATO.
  • Further external validation is necessary prior to clinical implementation.
Abstract

Keywords:
acute total occlusioncoronary angiographynon-ST-segment elevation myocardial infarctionrestricted cubic splinestress hyperglycemia ratio

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Psychoneuroimmunology: Diabetes and Cancer01:19

Psychoneuroimmunology: Diabetes and Cancer

Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...