The objective of this study was to investigate the association between the SHR and mortality and rehospitalization in patients with ADHF and. Understanding the impact of the SHR on mortality and rehospitalization in ADHF is important, as it may help clinicians identify high-risk patients and tailor their treatment strategies accordingly. Stress hyperglycemia is found to cause inflammation and endothelial dysfunction, which has been proven to be closely correlated with the prognosis of ADHF. However, there are limited data on the relationship between the SHR and mortality and rehospitalization in ADHF. The stress hyperglycemia ratio (SHR), which evaluates the extent of stress-related hyperglycemia in relation to the severity of illness, has been suggested as a potential indicator for predicting unfavorable outcomes in critically ill individuals. While stress hyperglycemia has been linked to worse outcomes in various acute medical conditions, its impact on mortality and rehospitalization in ADHF is poorly understood. Stress hyperglycemia, which refers to a temporary elevation in blood glucose levels triggered by physiological or psychological stress, is commonly observed among patients with ADHF. It defined as the deterioration of preexisting chronic HF that requires urgent medical attention. Conclusionīoth elevated and reduced SHRs indicate an unfavorable long-term prognosis in patients with ADHF and diabetes.Īcute decompensated heart failure (ADHF), is the most common form of acute heart failure (HF), accounting for 50–70% of presentations. Further analyses indicated that the U-shape association between the SHR and mortality remained significant in both HFpEF and HFrEF patients. Similarly, patients in the lowest range (1st quintile) of SHR also exhibited significantly increased risks of all-cause death (HR 2.33, 95% CI 1.35–4.02) and CV death (HR 2.32, 95% CI 1.35–4.00). Patients categorized in the highest range (5th quintile) of SHR, compared to those in the 2nd quintile, exhibited the greatest susceptibility to all-cause death (with a hazard ratio of 2.76 and a 95% confidence interval of 1.63–4.68), CV death (HR 2.81 ) and the highest rate of HF rehospitalization (HR 1.54 ). Kaplan–Meier survival analysis showed the lowest mortality in the 2nd quintile ( P = 0.0028). Restricted cubic spline analysis suggested a U-shaped association between the SHR and the mortality and rehospitalization rates. ResultsĪ total of 169 all-cause deaths were recorded during a median follow-up of 3.24 years. Further analyses were performed to examine the relationships between SHR and the outcomes in heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). A Cox proportional hazards model and restricted cubic spline analysis were used to elucidate the relationship between the SHR and the endpoints in diabetic ADHF patients. The secondary endpoints were cardiovascular (CV) death and heart failure (HF) rehospitalization at the 3-year follow-up. The primary endpoint was all-cause death at the 3-year follow-up. All diabetic ADHF subjects were divided into quintiles according to the SHR. Stress hyperglycemia was estimated using the stress hyperglycemia ratio (SHR), which was calculated by the following formula: SHR = admission blood glucose/. We consecutively enrolled 1904 ADHF patients. This study investigated the associations of stress hyperglycemia with mortality and rehospitalization rates among ADHF patients with diabetes. The relationship between stress hyperglycemia and long-term prognosis in acute decompensated heart failure (ADHF) patients is unknown.
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