Stress Hyperglycemia Ratio Is Associated with Intracardiac Thrombus in Acute Ischemic Stroke Akut İskemik İnmede Stres Hiperglisemi Oranı ile İntrakardiyak Trombüs Arasındaki İlişki
Turk Kardiyoloji Dernegi Arsivi, cilt.54, sa.5, ss.395-402, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 54 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.5543/tkda.2026.50611
- Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.395-402
- Anahtar Kelimeler: Acute ischemic stroke, cardioembolism, echocardiography, intracardiac thrombus, risk stratification, stress hyperglycemia ratio
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Transthoracic echocardiography (TTE) is widely used for cardiac evaluation in acute ischemic stroke (AIS), but it may miss intracardiac thrombi that can be detected by transesophageal echocardiography (TEE). The stress hyperglycemia ratio (SHR), which adjusts admission glucose for baseline glycemia, has emerged as a novel biomarker in cardiovascular disease. However, its association with intracardiac thrombus undetected by TTE in AIS remains unclear. Method: This retrospective study included 486 AIS patients who underwent TEE despite negative baseline TTE findings. Demographic, laboratory, and echocardiographic data were evaluated. Logistic regression and receiver operating characteristic (ROC) analysis were used to assess independent associations with intracardiac thrombus. Results: TEE detected thrombus in 64 patients (13.2%). Patients with thrombus had higher SHR (0.99 ± 0.42 vs. 0.84 ± 0.27, P < 0.001), glucose, C-reactive protein (CRP), and creatinine levels, and lower ejection fraction. In univariable analysis, SHR showed a strong association with intracardiac thrombus (odds ratio [OR] = 3.68, P < 0.001) and remained independently associated after multivariable adjustment (OR = 2.39, 95% confidence interval: 1.11–5.17, P = 0.027), along with CRP, paroxysmal atrial fibrillation, and male sex, while ejection fraction was inversely associated with thrombus presence. The model demonstrated good discriminative performance (area under the curve: 0.796). Conclusion: SHR is associated with intracardiac thrombus missed by TTE but detected by TEE in AIS. SHR may enhance risk stratification and help guide selective use of TEE.