Association of Stress Hyperglycemia Ratio with Intracoronary Thrombus Burden in Diabetic Patients with ST Segment Elevation Myocardial Infarction | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.435557.4278 | ||
| Authors | ||
| Baher Nabil Nashy1; Ghada Ibrahim Mohammed2; Mahmoud Mohammed Ali Ibrahim* 3; Radwa Mohammed Khalil4 | ||
| 1Assistant Professor of Cardiology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Professor of Cardiology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt | ||
| 4Lecturer of Cardiology department, Faculty of Medicine, Zagazig University, Egypt | ||
| Abstract | ||
| Background: Hyperglycemia brought on by stress is prevalent in STEMI and is associated with negative consequences. Acute glycemic stress in relation to chronic control is shown by the stress hyperglycemia ratio. The purpose of this study was to evaluate the relationship between SHR and intracoronary thrombus load. Methods: 59 diabetic patients (mean age 57.49, ages 41–75) who were receiving primary percutaneous coronary intervention and presenting with ST-segment elevation myocardial infarction were included in this cross-sectional study. Patients were divided into two groups based on the angiographic evaluation of thrombus load: small thrombus burden (STB) for grades 0–3, and large thrombus burden for grades 4–5. By dividing the entrance glucose by the estimated average glucose based on HbA1c ((28.7×HbA1c)/- 46.7), the stress hyperglycemia ratio (SHR) was computed. According to this classification, there were 45 patients (76.3%) in Group I (LTB) and 14 patients (23.7%) in Group II (STB). Results: Compared to patients with small thrombus load (STB), those with large thrombus burden (LTB) had substantially higher random blood glucose (p=0.036) and stress hyperglycemia ratios (SHR) (1.83±0.42vs. 1.27±0.64; p<0.001). In regression analysis, SHR was the only independent predictor of LTB (AOR= 2.28, 95% CI 1.36–110.89; p=0.026). ROC analysis identified an SHR cutoff ≥1.262 for predicting LTB (AUC=0.827, sensitivity 95.6%, specificity 78.6%), and SHR ≥1.505 predicted post-PCI TIMI III flow (AUC=0.71; p=0.031). Conclusion: In diabetic STEMI patients, elevated SHR is a powerful independent predictor of significant intracoronary thrombus burden and poor reperfusion, indicating its potential utility for early risk assessment and therapy optimization. | ||
| Keywords | ||
| Stress hyperglycemia ratio; STEMI; Diabetes mellitus; Thrombus burden; Primary PCI | ||
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