Key result
A higher stress hyperglycaemia ratio was significantly associated with adverse left ventricular remodelling, including a reduction in left ventricular ejection fraction, at 6 months after STEMI.
Why the study?
Left ventricular negative remodelling post-STEMI causes poor prognosis, but its predisposing factors and mechanisms remain incompletely understood.
Does a high stress hyperglycaemia ratio predict left ventricular negative remodelling in patients with first-time acute anterior STEMI?
Cohort (n=127)
Yes
Does a high stress hyperglycaemia ratio predict left ventricular negative remodelling in patients with first-time acute anterior STEMI?
Mean Difference: -9.825 (95% CI -15.168–-4.481)
p-value: p=<0.0001
The stress hyperglycaemia ratio is significantly and independently associated with left ventricular negative remodelling and greater myocardial injury after first-time acute anterior STEMI.
Should not yet change post-STEMI care; hypothesis-generating for glycaemic targets in remodelling prevention.
BACKGROUND: Left ventricular negative remodelling after ST-segment elevation myocardial infarction (STEMI) is considered as the major cause for the poor prognosis. But the predisposing factors and potential mechanisms of left ventricular negative remodelling after STEMI remain not fully understood. The present research mainly assessed the association between the stress hyperglycaemia ratio (SHR) and left ventricular negative remodelling. METHODS: We recruited 127 first-time, anterior, and acute STEMI patients in the present study. All enrolled patients were divided into 2 subgroups equally according to the median value of SHR level (1.191). Echocardiography was conducted within 24 h after admission and 6 months post-STEMI to measure left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD). Changes in echocardiography parameters (δLVEF, δLVEDD, δLVESD) were calculated as LVEF, LVEDD, and LVESD at 6 months after infarction minus baseline LVEF, LVEDD and LVESD, respectively. RESULTS: In the present study, the mean SHR was 1.22 ± 0.25 and there was significant difference in SHR between the 2 subgroups (1.05 (0.95, 1.11) vs 1.39 (1.28, 1.50), p < 0.0001). The global LVEF at 6 months post-STEMI was significantly higher in the low SHR group than the high SHR group (59.37 ± 7.33 vs 54.03 ± 9.64, p = 0.001). Additionally, the global LVEDD (49.84 ± 5.10 vs 51.81 ± 5.60, p = 0.040) and LVESD (33.27 ± 5.03 vs 35.38 ± 6.05, p = 0.035) at 6 months after STEMI were lower in the low SHR group. Most importantly, after adjusting through multivariable linear regression analysis, SHR remained associated with δLVEF (beta = -9.825, 95% CI -15.168 to -4.481, p < 0.0001), δLVEDD (beta = 4.879, 95% CI 1.725 to 8.069, p = 0.003), and δLVESD (beta = 5.079, 95% CI 1.421 to 8.738, p = 0.007). CONCLUSIONS: In the present research, we demonstrated for the first time that SHR is significantly correlated with left ventricular negative remodelling after STEMI.
No takes yet. Share an insight, caveat, or question.
Meng et al. (2021) conducted a cohort in First-time, acute, anterior ST-segment elevation myocardial infarction (STEMI) (n=127). Stress hyperglycaemia ratio (SHR) vs. Low SHR (< 1.191) was evaluated on Change in left ventricular ejection fraction (δLVEF) at 6 months (beta -9.825, 95% CI -15.168 to -4.481, p=<0.0001). A higher stress hyperglycaemia ratio was significantly associated with adverse left ventricular remodelling, including a reduction in left ventricular ejection fraction, at 6 months after STEMI.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: