Objective:To explore the predictive value of stress hyperglycemia ratio(SHR)for new-onset atrial fibrillation(NOAF)in patients with ST-segment elevation myocardial infarction(STEMI).Methods:This retrospective cohort study included 437 STEMI patients undergoing PCI.Patients were divided into two groups based on SHR levels:Low SHR group(SHR＜0.83,n=214)and High SHR group(SHR ≥ 0.83,n=223).SHR was calculated using the formula:In-hospital blood glucose/[(28.7 × HbA1c％)-46.7].The primary endpoints were 30-day NOAF and 3-year NOAF.The Cox regression model was employed to analyze the correlation between SHR and both 30-day and 3-year NOAF.Locally weighted scatterplot smoothing(Lowess)curves were plotted to evaluate the impact of SHR levels on the NOAF outcome.Receiver operating characteristic(ROC)curve analysis and area under the curve(AUC)were used to assess the predictive efficacy of SHR for 3-year NOAF.Results:Patients in the high SHR group exhibited higher levels of blood glucose,hs-CRP,and a higher proportion of oral hypoglycemic agents.Multivariate regression analysis revealed an independent positive correlation between high SHR and a 3-year NOAF risk in STEMI patients(HR=2.24,95％CI:1.06-4.74,P=0.034).However,there was no significant correlation between high SHR and 30-day NOAF.Lowess curves indicated a"J"-shaped correlation between SHR as a continuous variable and the risk of 3-year NOAF.ROC curves demonstrated that SHR had a certain predictive capability for the 3-year NOAF outcome(AUC=0.711,95％CI:0.666-0.754).Conclusions:As a readily available laboratory indicator,SHR can serve as a predictive factor for the occurrence of 3-year NOAF in STEMI patients in clinical practice.
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