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Zhou Y, Liu L, Huang H, Li N, He J, Yao H, Tang X, Chen X, Zhang S, Shi Q, Qu F, Wang S, Wang M, Shu C, Zeng Y, Tian H, Zhu Y, Su B, Li S. 'Stress hyperglycemia ratio and in-hospital prognosis in non-surgical patients with heart failure and type 2 diabetes. Cardiovasc Diabetol 2022; 21:290. [PMID: 36572923 PMCID: PMC9791974 DOI: 10.1186/s12933-022-01728-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/15/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the impact of stress hyperglycemia on the in-hospital prognosis in non-surgical patients with heart failure and type 2 diabetes. RESEARCH DESIGN AND METHODS We identified non-surgical hospitalized patients with heart failure and type 2 diabetes from a large electronic medical record-based database of diabetes in China (WECODe) from 2011 to 2019. We estimated stress hyperglycemia using the stress hyperglycemia ratio (SHR) and its equation, say admission blood glucose/[(28.7 × HbA1c)- 46.7]. The primary outcomes included the composite cardiac events (combination of death during hospitalization, requiring cardiopulmonary resuscitation, cardiogenic shock, and the new episode of acute heart failure during hospitalization), major acute kidney injury (AKI stage 2 or 3), and major systemic infection. RESULTS Of 2875 eligible Chinese adults, SHR showed U-shaped associations with composite cardiac events, major AKI, and major systemic infection. People with SHR in the third tertile (vs those with SHR in the second tertile) presented higher risks of composite cardiac events ([odds ratio, 95% confidence interval] 1.89, 1.26 to 2.87) and major AKI (1.86, 1.01 to 3.54). In patients with impaired kidney function at baseline, both SHR in the first and third tertiles anticipated higher risks of major AKI and major systemic infection. CONCLUSIONS Both high and low SHR indicates poor prognosis during hospitalization in non-surgical patients with heart failure and type 2 diabetes.
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Affiliation(s)
- Yiling Zhou
- grid.13291.380000 0001 0807 1581 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Li Liu
- Department of Endocrinology and Metabolism, Second People’s Hospital of Ya’an City, Ya’an, 625000 China
| | - Hongmei Huang
- Department of Endocrinology and Metabolism, The First People’s Hospital of Shuangliu District, Chengdu, 610200 China
| | - Nan Li
- grid.13291.380000 0001 0807 1581The Informatic Center, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Jidong He
- Department of Endocrinology and Metabolism, Second People’s Hospital of Ya’an City, Ya’an, 625000 China
| | - Heling Yao
- Department of Endocrinology and Metabolism, Second People’s Hospital of Ya’an City, Ya’an, 625000 China
| | - Xiaochi Tang
- Department of Endocrinology and Metabolism, The First People’s Hospital of Shuangliu District, Chengdu, 610200 China
| | - Xiangyang Chen
- grid.13291.380000 0001 0807 1581 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 China ,Department of Endocrinology and Metabolism, The First People’s Hospital of Shuangliu District, Chengdu, 610200 China
| | - Shengzhao Zhang
- grid.459690.7Department of Pharmacy, Karamay Central Hospital, Karamay, 834000 China ,grid.13291.380000 0001 0807 1581Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Qingyang Shi
- grid.13291.380000 0001 0807 1581Chinese Evidence-Based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Furong Qu
- grid.13291.380000 0001 0807 1581 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581Department of General Practice, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Si Wang
- grid.13291.380000 0001 0807 1581Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Miye Wang
- grid.13291.380000 0001 0807 1581The Informatic Center, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Chi Shu
- grid.13291.380000 0001 0807 1581Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Yuping Zeng
- grid.13291.380000 0001 0807 1581Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Haoming Tian
- grid.13291.380000 0001 0807 1581 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Ye Zhu
- grid.13291.380000 0001 0807 1581Department of Cardiology, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Baihai Su
- grid.13291.380000 0001 0807 1581Department of Nephrology, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Sheyu Li
- grid.13291.380000 0001 0807 1581 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581Chinese Evidence-Based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, 610041 China
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