Association of the stress hyperglycemia ratio (SHR) with 90-day and 180-day all-cause mortality in patients undergoing coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI): A retrospective cohort study using the MIMIC-IV database.

Stress hyperglycemia ratio (SHR) is established as a predictor of adverse outcomes among patients with cardiovascular and cerebrovascular diseases. However, its relationship with prognosis in patients undergoing coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) remains inconclusive. This study aimed to explore the association of SHR with short-term mortality among this specific patient population. A retrospective cohort study was conducted by analyzing data from 1006 patients who underwent CABG for AMI, extracted from the Medical Information Mart for Intensive Care IV (version 3.1) database. Patients were stratified into tertiles according to SHR levels. Cox proportional hazards models, including a segmented version, were applied to evaluate the relationship between SHR and mortality at both 90 and 180 days. Within the study population, 47 patients (4.67%) died within 90 days, and 60 patients (5.96%) within 180 days. After adjustment for multiple covariates, patients in the highest SHR tertile exhibited a substantially higher mortality risk at 90 and 180 days compared to those in the lowest tertile (T3 vs T1: hazard ratio 3.78-4.19, P < .001 for both, trend P < .001). Our findings indicate that elevated SHR, measured by the glucose/hemoglobin A1c ratio, is associated with higher short-term mortality in patients undergoing CABG for AMI. The restricted cubic spline model showed that all-cause mortality at 90 and 180 days was positively associated with SHR levels.