Association between stress hyperglycemia ratio and 28-day all-cause mortality in patients with coronary artery disease

The stress hyperglycemia ratio (SHR) is significantly associated with the risk of poor prognosis in cardiovascular disease. However, studies regarding the association between SHR and prognosis in patients with coronary artery disease (CAD) admitted to the intensive care unit (ICU) remain limited. CAD patients admitted to the ICU were identified from the MIMIC-IV 2.2 database and was divided into four groups according to SHR levels. The primary outcome was 28-day all-cause mortality and the secondary outcome was in-hospital mortality. The association between SHR and clinical outcomes in CAD patients admitted to the ICU was analyzed using Cox regression, Kaplan-Meier curves, and restricted cubic spline (RCS) analysis. A total of 2287 patients were included, with a 28-day all-cause mortality rate of 12.1% and an in-hospital mortality rate of 9.9%. Higher SHR levels were significantly associated with increased risk of 28-day mortality and in-hospital mortality in patients, regardless of adjustment for confounders. RCS analysis detected no evidence of a non-linear association between SHR and 28-day all-cause mortality. In CAD patients admitted to the ICU, higher SHR levels were significantly associated with increased risk of 28-day all-cause mortality and in-hospital mortality. No evidence of a non-linear association between SHR levels and 28-day all-cause mortality. However, large-scale, prospective cohort studies are needed to further confirm its causal relationship.