Stress hyperglycemia ratio, Coronary artery disease, Coronary artery bypass grafting, Prognosis, Glucose metabolic states, Diseases of the circulatory (Cardiovascular) system, RC666-701

Abstract Background Stress hyperglycemia ratio (SHR) is recognized as a reliable indicator of acute hyperglycemia during stress. Patients undergoing coronary artery bypass grafting (CABG) are at high risk of stress hyperglycemia, but little attention has been paid to this population. This study is the first to investigate the association between SHR and both short-term and long-term prognosis in CABG patients, with a further exploration of the impact of SHR across different glucose metabolic states. Methods A total of 18,307 patients undergoing isolated CABG were consecutively enrolled and categorized into three groups based on SHR tertiles. The perioperative outcome was defined as a composite of in-hospital death, myocardial infarction, cerebrovascular accident, and reoperation during hospitalization. The long-term outcome was major adverse cardiovascular and cerebrovascular events (MACCEs). Restricted cubic spline and logistic regression linked SHR to perioperative risks. Kaplan–Meier and Cox regression analyses were used to determine the relationship with long-term prognosis. Subgroup analyses were further conducted based on different glucose metabolic states. Results A U-shaped association was observed between SHR and perioperative outcome in the overall population (P for nonlinear