Relationship Between Stress Hyperglycemia Ratio and In-Stent Restenosis in Patients Receiving Drug-Eluting Stents

<b>Aims/Background</b> In-stent restenosis (ISR) is a major cause of long-term failure in coronary revascularization among patients undergoing percutaneous coronary intervention (PCI). Emerging evidence suggests that the stress hyperglycemia ratio (SHR) is a novel biomarker with potential predictive value for cardiovascular diseases. This study aimed to investigate the relationship between SHR and ISR in patients treated with drug-eluting stents (DES). <b>Methods</b> This retrospective study included 410 patients who underwent DES implantation at the Cardiology Department of Yixing People's Hospital between January 2015 and December 2022. All participants underwent coronary angiography (CAG) to evaluate the incidence of ISR and were categorized into two groups based on CAG results: non-ISR (n = 346) and ISR (n = 64). Laboratory parameters were evaluated prior to CAG for all participants. A restricted cubic spline (RCS) analysis was performed to evaluate the potential nonlinear associations between SHR and ISR. Multivariate logistic regression was used to identify independent risk factors for ISR, while the predictive value of SHR for ISR was assessed using receiver operating characteristic (ROC) analysis. <b>Results</b> RCS analysis revealed a nonlinear, J-shaped relationship between SHR and ISR (<i>p</i> < 0.05). Multivariate logistic regression identified SHR as an independent risk factor of ISR (odds ratio (OR) = 32.05, 95% confidence interval (CI): 6.827-150.450, <i>p</i> < 0.05). ROC analysis revealed that SHR had a high predictive value for ISR, with an area under the curve (AUC) of 0.81 (95% CI: 0.74-0.87, <i>p</i> < 0.001). The optimal SHR cutoff value was 0.87, with a sensitivity of 79.69% and a specificity of 73.41%. <b>Conclusion</b> Our findings identified a significant association between SHR and the risk of ISR in patients with coronary heart disease (CHD) undergoing PCI with DES implantation. SHR may serve as a valuable biomarker for predicting ISR, enabling improved risk stratification and patient management.