Admission hyperglycemia in acute myocardial infarction is associated with an increased risk of arrhythmias: A systematic review and meta‐analysis

Abstract

Background: Admission hyperglycemia (AH) has shown to be associated with higher mortality rates in acute myocardial infarction (AMI). Malignant arrhythmia is one of the causes of death in AMI; however, it is unclear whether AH is associated with an increased arrhythmia risk. We conducted this systematic review and meta-analysis to assess the association between AH and arrhythmias in AMI. Methods:We searched MEDLINE, and Embase databases from inception to September 2021 to identify studies that compared arrhythmia rates between AMI patients with AH and those without. Arrhythmias of interest included ventricular tachyarrhythmias (VA), atrial fibrillation (AF), and atrioventricular block. Results:Thirteen cohort studies with a total of 12,898 patients were included. AH was associated with a higher risk of overall arrhythmias (18% vs 10.3%, pooled odds ratio [OR]

Analysis of gut microbiota in patients with acute myocardial infarction by 16S rRNA sequencing

“…Acute myocardial infarction (AMI) is caused by myocardial necrosis due to an acute or persistent reduction in the coronary artery blood supply and an insufficient oxygen supply ( 1 ). AMI is often accompanied by malignant arrhythmia, cardiogenic shock, and even sudden death ( 2 ). With the aging population, stresses of modern life, changes in eating habits, and influence of social and psychological factors, cardiovascular disease-related deaths, such as coronary heart disease and AMI, have become the primary cause of human mortality and pose a serious threat to human health.…”

Impact of hybrid closed‐loop insulin delivery on cardiac rhythm in older adults with type 1 diabetes: A post hoc analysis of trial data

“…Animal studies have shown that acute hyperglycaemia can enhance cellular pro‐arrhythmic mechanisms 14,15 . Meta‐analysis of patients admitted with myocardial infarction has suggested that hyperglycaemia is associated with higher risks of arrhythmia 16 . These findings may be relevant to our population, as older people with T1D have higher risks of arrhythmia and myocardial infarction than the general population 1,4 .…”

Association of stress hyperglycemia ratio with in‐hospital new‐onset atrial fibrillation and long‐term outcomes in patients with acute myocardial infarction

“…Notably, all of the included studies in this meta-analysis had described hyperglycemia merely using the ABG or FBG, which did not account for the chronic rise in baseline glucose levels. 9 In our study, the SHR that combined information provided by acute and chronic glycaemic levels was used to characterise stress hyperglycemia. A novel finding is that the SHR was an independent predictor of post-MI NOAF, which was more pronounced in patients without diabetes than in those with diabetes.…”

“…performed a meta‐analysis of 13 cohort studies with 12898 AMI patients included and found that admission hyperglycemia was associated with a nearly 2‐fold increased risk of NOAF (OR: 2.13, 95% CI: 1.40–3.25, p < 0.001) when compared to normoglycemia. Notably, all of the included studies in this meta‐analysis had described hyperglycemia merely using the ABG or FBG, which did not account for the chronic rise in baseline glucose levels 9 …”

“…8 Acute hyperglycemia caused by increased secretion of glucagon, catecholamines, and steroids, as well as decreased insulin production because of stress reaction (so-called 'stress hyperglycemia') often occurs in AMI patients, while the association between stress hyperglycemia and post-MI NOAF remains unclear. It is worth noting that the majority of prior studies have simply used either admission blood glucose (ABG) or fasting blood glucose (FBG) to measure stress hyperglycemia, 9 ignoring the influence of chronic glucose levels, and therefore may not reflect the 'true' stress hyperglycemia, particularly in diabetics.…”