ArticleCardiovascular diabetology2017
Relative hyperglycemia is associated with complications following an acute myocardial infarction: a post-hoc analysis of HI-5 data.
Article in Cardiovascular diabetology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Prognostic value of HbA1c for in-hospital and short-term mortality in patients with acute coronary syndrome: a systematic review and meta-analysis.Cardiovascular diabetology · 2019Pooled it
- Acute hyperglycemia, a rabble-rouser or innocent bystander? A prospective analysis of clinical implications of acute hyperglycemia in STE-ACS patients.BMC cardiovascular disorders · 2023Trial
- Prognostic significance of stress hyperglycemia ratio in patients with type 2 diabetes mellitus and acute coronary syndromes.Thrombosis journal · 2025Article
- The correlation between the atherogenic index of plasma and the severity of coronary artery disease in acute myocardial infarction patients under different glucose metabolic states.Scientific reports · 2025Article
- Positive association between stress hyperglycemia ratio and ICU mortality in patients with pulmonary embolism: A retrospective study.PloS one · 2025Article
- Targeted Antioxidant Therapy Reduces Hyperglycemic Exacerbation of Myocardial Ischemia/Reperfusion Injury.The Journal of surgical research · 2024Article
- Potential Benefits of Continuous Glucose Monitoring for Predicting Vascular Outcomes in Type 2 Diabetes: A Rapid Review of Primary Research.Healthcare (Basel, Switzerland) · 2024Review
- Article
- Association of acute glycemic parameters at admission with cardiovascular mortality in the oldest old with acute myocardial infarction.Journal of geriatric cardiology : JGC · 2024Article
- Prognostic implications of stress hyperglycemia ratio in patients with myocardial infarction with nonobstructive coronary arteries.Annals of medicine · 2023Article
- Stress hyperglycemia ratio and long-term prognosis in patients with acute coronary syndrome: A multicenter, nationwide study.Journal of diabetes · 2023Article
- Does hyperglycemia affect arginine metabolites in critically ill patients? A prospective cohort and in vitro study.Diabetology & metabolic syndrome · 2023Article
- Association between time in range of relative normoglycemia and in-hospital mortality in critically ill patients: a single-center retrospective study.Scientific reports · 2022Article
- Predictive value of the stress hyperglycemia ratio in patients with acute ST-segment elevation myocardial infarction: insights from a multi-center observational study.Cardiovascular diabetology · 2022Observational
- Body Mass Index Enhances the Associations Between Plasma Glucose and Mortality in Patients with Acute Coronary Syndrome.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- Association between Changes in the Systolic Blood Pressure from Evening to the Next Morning and Night Glucose Variability in Heart Disease Patients.Internal medicine (Tokyo, Japan) · 2021Article
- Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients.Cardiovascular diabetology · 2021Article
- Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes.BMC cardiovascular disorders · 2021Observational
- Stress hyperglycemia, cardiac glucotoxicity, and critically ill patient outcomes current clinical and pathophysiological evidence.Physiological reports · 2021Review
- Development and Validation of a Simple-to-Use Nomogram for Predicting In-Hospital Mortality in Patients With Acute Heart Failure Undergoing Continuous Renal Replacement Therapy.Frontiers in medicine · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHyperglycemia is associated with increased morbidity and mortality in patients with an acute myocardial infarction (AMI). We evaluated whether complications after AMI are associated with absolute or relative glycemia.
methodsA total of 192 patients with AMI were randomized to intensive or conventional insulin therapy. Absolute glycemia was defined as mean blood glucose level (BGL) during the first 24 h following randomization. Relative glycemia was defined by the stress hyperglycaemia ratio (SHR), calculated as mean BGL divided by average glucose concentration over the prior 3 months estimated from glycosylated haemoglobin. The primary endpoint was a "complicated AMI", defined as an AMI complicated by death, congestive cardiac failure, arrhythmia, cardiac arrest, reinfarction, cardiogenic shock, inotrope use or emergency revascularization.
resultsThere was not a significant association between mean BGL and complicated AMI (odds ratio (OR) 1.05 per mmol/L glucose increment, 95% confidence intervals (CI) 0.93-1.19). In contrast, SHR was positively associated with a complicated myocardial infarction (OR 1.22 per 0.1 SHR increment, 95% CI 1.06-1.42), and individual complications of death (OR 1.55, 95% CI 1.14-2.11), congestive cardiac failure (OR 1.27, 95% CI 1.05-1.54), arrhythmia (OR 1.31, 95% CI 1.12-1.54) and cardiogenic shock (OR 1.42, 95% CI 1.03-1.97). The relationship between SHR and a complicated AMI was independent of diabetic status, intensive insulin therapy, sex and hypoglycemia.
conclusionsRelative, but not absolute, glycemia during insulin treatment is independently associated with complications after an AMI. Future studies should investigate whether basing therapeutic glycaemic targets on relative glycemia improves patient outcomes.
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