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Although SHR has been proposed as a better prognostic marker than absolute glucose levels, its quantitative relationship with in-hospital mortality in acute myocardial infarction (AMI) remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to August 10, 2025. Observational studies reporting the association between SHR and in-hospital mortality in AMI were included. Quality assessment was performed using the Newcastle\u2013Ottawa Scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random-effects model. The dose\u2013response relationships were analyzed using the Greenland and Longnecker method and restricted cubic spline models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven studies involving 27,343 patients were included. Higher SHR was significantly associated with increased in-hospital mortality (pooled OR\u2009=\u20092.14; 95% CI: 1.74\u20132.55; I\u00b2 = 63%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The association remained basically consistent across subgroups and sensitivity analysis. Furthermore, the restricted cubic spline model illustrated a non-linear dose-response association between SHR and in-hospital mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with AMI, an elevated SHR is consistently and non-linearly associated with a higher risk of in-hospital mortality. These findings suggest that SHR may serve as a valuable prognostic tool for early risk stratification, although further prospective studies are needed to confirm its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05845-2","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:06:40Z","timestamp":1778058400000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between stress hyperglycemia ratio and in-hospital mortality in acute myocardial infarction: a dose-response meta-analysis"],"prefix":"10.1186","volume":"26","author":[{"given":"Wei","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Shu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuolin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengjin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"5845_CR1","doi-asserted-by":"publisher","first-page":"100803","DOI":"10.1016\/j.lanwpc.2023.100803","volume":"37","author":"NWS Chew","year":"2023","unstructured":"Chew NWS, Chong B, Kuo SM, Jayabaskaran J, Cai M, Zheng H, et al. 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