# The predictive value of the C-reactive protein-stress hyperglycemia ratio for in-hospital major adverse cardiovascular events in patients with ST-segment elevation myocardial infarction

## TL;DR

This study shows that a new biomarker called CSR can predict major heart complications in patients with a specific type of heart attack.

## Contribution

The study introduces and validates the C-reactive protein-stress hyperglycemia ratio (CSR) as a novel predictor of in-hospital MACE in STEMI patients.

## Key findings

- CSR was significantly higher in patients who experienced MACE compared to those who did not.
- CSR was identified as an independent risk factor for in-hospital MACE in STEMI patients.
- The relationship between CSR and MACE risk was linear and consistent across subgroups.

## Abstract

High-sensitivity C-reactive protein (hs-CRP) and stress hyperglycemia ratio (SHR) are recognized as predictors of major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). To comprehensively evaluate their combined contribution, we proposed the high-sensitivity C-reactive protein-stress hyperglycemia ratio (CSR). This study aims to assess the predictive value of CSR for in-hospital MACE in STEMI patients.

This single-center retrospective analysis enrolled patients with STEMI admitted to the Third Affiliated Hospital of Anhui Medical University between October 1, 2021 and June 1, 2025. Based on the incidence of in-hospital major adverse cardiovascular events (MACE), the patients were categorized into MACE and non-MACE groups. Univariate and multivariate logistic regression analyses, restricted cubic spline (RCS) curves, receiver operating characteristic (ROC) curve analysis, and subgroup analyses were conducted to examine the relationship between CSR and in-hospital MACE in STEMI patients.

A total of 246 patients were enrolled, with 56 assigned to the MACE group and 190 to the non-MACE group. The CSR value was significantly higher in the MACE group than in the non-MACE group (P < 0.05). Multivariate logistic regression analysis showed that CSR was an independent risk factor for in-hospital MACE in STEMI patients (OR = 1.207, 95% CI: 1.024–1.423, P = 0.025). Restricted cubic spline analysis revealed a linear positive correlation between CSR and the risk of in-hospital MACE (P for non-linearity > 0.05). Subgroup analysis indicated that the association between CSR and in-hospital MACE risk was consistent across all subgroups.

CSR is a reliable biomarker for predicting in-hospital MACE in STEMI patients. It may help optimize early risk stratification and potentially improve prognosis in high-risk patients.