title: The stress hyperglycemia ratio, an index of relative hyperglycemia, as a predictor of clinical outcomes after percutaneous coronary intervention.
abstract: BACKGROUND
  We aimed to investigate the outcome-predicting value of a novel index of stress hyperglycemia in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI).
  
  
  METHODS
  This was a retrospective observational study. Four-thousand-three-hundred-sixty-two subjects from the COACT registry were used to estimate the risk of major adverse cardiovascular and cerebrovascular events (MACCE), which are defined as composites of all-cause death, non-fatal myocardial infarction (MI) and non-fatal stroke. The stress hyperglycemia ratio (SHR) was calculated by dividing the random serum glucose at admission with the estimated average glucose derived from HbA1c.
  
  
  RESULTS
  Over a median follow-up of 2.5years, 344 (7.9%), 43 (1.0%), and 89 (2.0%) cases of death, non-fatal MI, and non-fatal stroke occurred, respectively. Compared with the subjects in the lower three quartiles of SHR, the HR (95% CI) for the highest SHR quartile (Q4) group for MACCE was 1.31 (1.05, 1.64) in the total population and 1.45 (1.02, 2.06) in the non-diabetic population after adjusting for potential covariables. The risk of MACCE in the SHR Q4 group was significantly higher in patients presenting with ST-elevation MI (STEMI), which was not the case for patients presenting with other CAD types. The prognostic impact of SHR was more prominent for the 30-day MACCE. Similar results were observed in another cohort consisting of patients who only presented with acute MI.
  
  
  CONCLUSIONS
  SHR is a useful predictive marker of MACCE after PCI, especially in non-diabetic patients with STEMI, which could be utilized to identify high-risk patients for adverse outcomes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Yeoree
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kun-Ho
authors.initials: KH
authors.lastname: Yoon
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University, Gwangju, Republic of Korea.
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: hwanx2@catholic.ac.kr.
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: kiyuk@catholic.ac.kr.
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000639:trends*; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Coronary artery disease; Diabetes; Major adverse cardiovascular and cerebrovascular events; Percutaneous coronary intervention; Stress hyperglycemia ratio