Association of stress hyperglycemia ratio with short-term and long-term prognosis in patients undergoing coronary artery bypass grafting across different glucose metabolism states: a large-scale cohort study

WHAT IS CURRENTLY KNOWN ABOUT THIS TOPIC?: Stress hyperglycemia is common during the perioperative period in CABG patients and is linked to adverse short- and long-term outcomes. The stress hyperglycemia ratio (SHR) is a novel metric that accounts for baseline glycemia to better reflect acute stress-induced hyperglycemia. However, SHR has not been studied in the CABG population. WHAT IS THE KEY RESEARCH QUESTION?: This study is the first to investigate the association between SHR and both short-term and long-term prognosis in patients undergoing CABG, while further exploring its impact across different glucose metabolic states, categorized as normal glucose regulation, prediabetes, and diabetes. WHAT IS NEW?: In CABG patients, SHR shows a U-shaped relationship with perioperative events and a linear positive association with long-term outcomes, both of which are modulated by glucose metabolic status. HOW MIGHT THIS STUDYINFLUENCE CLINICAL PRACTICE?: Findings support the incorporation of SHR for risk stratification and personalized glucose management in CABG patients, ultimately improving both in-hospital and long-term prognosis.