The Study On Value Of Stress Hyperglycemia Ratio In Predicting The Prognosis Of Acute Heart Failure

Objectives: To explore the predictive value of stress hyperglycemia for 30-day mortality in acute heart failure(AHF)patients with or without diabetes,and compare the predicting abilities among immediate blood glucose,ΔBG and SHR.Methods: A total of 457 AHF patients was retrospectively included from emergency department in December 2016-January 2020,the immediate blood glucose,glycosylated hemoglobin(HbA1c)and other clinical datas were recorded,SHR and the glucose interval(ΔBG)were calculated by the mathematical model respectively,SHR= immediate admission blood glucose(mmol/L)/ [(1.59 x HbA1c)-2.59],chronic blood glucose levels(CBG)= 28.7(mg/d L)x HbA1c-46.7,and ΔBG= immediate blood glucose(mmol/L)-CBG(mmol/L).Divide the patients into diabetes mellitus(DM)group(n = 173)and non-diabetes mellitus(non-DM)group(n =284),survivor group(n = 388)and non-survivor group(n = 69)respectively,compare the differences of basic information.Use Spearman correlation analysis,Logistic regression,the receiver-operating characteristic curve(ROC),the area under the curve(AUC)and Kaplan-Meier analysis to evaluate the relationship between 30-day mortality and stress hyperglycemia.Results: A total of 457 AHF patients were included in the study,including 229males(50.1%)with an median age of 83(74,87)years.69 patients(15.1%)died within30-days follow-up.The 30-day mortality rate in the higher immediate blood glucose group was higher than that of the low group([21.6%] vs.[8.7%],p <0.001).ΔBG and SHR were positively correlated with 30-day mortality,and the correlation coefficients were 0.284 and 0.296(all p <0.001).The AUC of SHR,ΔBG and immediate blood glucose for predicting 30-day mortality of AHF patients were 0.766,0.762,and 0.669(all p <0.001),the Kaplan-Meier survival curve was drawn according to the best diagnostic values,differences between groups are statistically significant(p <0.001),only SHR(OR = 5.569,95% CI [1.372-22.608],p = 0.016)was an independent risk factor of 30-day mortality.Conclusions: This study found that stress hyperglycemia is related to 30-day mortality of AHF patients.SHR is an independent risk factor for 30-day death,it can predict 30-day mortality of AHF patients with or without DM.When the SHR exceeds the best predictive value of 1.10,the risk of death in AHF patients increases significantly.