IMR Press / RCM / Volume 24 / Issue 4 / DOI: 10.31083/j.rcm2404103
Open Access Original Research
Impact of the Stress Hyperglycemia Ratio on In-Hospital and Long-Term Poor Prognosis in Patients with Acute Myocarditis
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1 State Key Laboratory of Cardiovascular Disease, Department of Special Care Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
2 Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
3 Emergency and Critical Care Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
4 Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, 100191 Beijing, China
*Correspondence: tangyida@bjmu.edu.cn (Yi-Da Tang)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(4), 103; https://doi.org/10.31083/j.rcm2404103
Submitted: 11 September 2022 | Revised: 2 December 2022 | Accepted: 13 December 2022 | Published: 4 April 2023
(This article belongs to the Section Cardiovascular Endocrinology and Metabolism)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Few studies have focused on the impact of stress hyperglycemia on adverse outcomes in patients with acute myocarditis. We conducted the present study to assess the association between the stress hyperglycemia ratio (SHR) and poor prognosis in patients with acute myocarditis. Methods: From 2006 to 2020, 185 patients with acute myocarditis were enrolled. The SHR was defined as glucose at admission divided by estimated average glucose ([(1.59 × HbA1c %) – 2.59], glycated hemoglobin [HbA1c]). Participants were divided into two groups according to their SHR values. The primary endpoint was defined as in-hospital major adverse cardiovascular events (MACE), including death, heart transplantation, the need for mechanical circulatory support (MCS), and transfer to the intensive care unit (ICU). The secondary endpoint was defined as long-term MACE. Results: Subjects in the higher SHR group had more serious conditions, including lower systolic blood pressure, higher heart rate, higher white blood cell count, higher levels of alanine transaminase, troponin I, and C-reactive protein, and worse cardiac function. Multivariate logistic analysis showed that SHR >1.12 (hazard ratio (HR): 3.946, 95% confidence interval (CI): 1.098–14.182; p = 0.035) was independently associated with in-hospital MACE in patients with acute myocarditis. Kaplan-Meier survival analysis and multivariate Cox analysis suggested that an SHR >1.39 (HR: 1.931, 95% CI: 0.323–2.682; p = 0.895) was not significantly associated with long-term prognosis. Conclusions: SHR was independently associated with in-hospital adverse outcomes in patients with acute myocarditis but not with long-term prognosis.

Keywords
SHR
hyperglycemia
biomarker
acute myocarditis
prognosis
Funding
2020YFC2004705/National Key R&D Program of China
2021RU003/Research Unit of Medical Science Research Management/Basic and Clinical Research of Metabolic Cardiovascular Diseases from Chinese Academy of Medical Sciences
81825003/National Natural Science Foundation of China
91957123/National Natural Science Foundation of China
Z201100006820002/Beijing Nova Program from Beijing Municipal Science & Technology Commission
XCSTS-SD2021-01/Science and Technology Project of Xicheng District Finance
Figures
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