Impact of Hyperglycemia on Clinical Outcome in Patients Undergoing Percutaneous Coronary Intervention (Pci) for St-Segment Elevation Myocardial Infarction (Stemi)

Monte, Ariella De; Perkan, Andrea; Vitrella, Giancarlo; Rakar, Serena; Grazia, Erica Della; Salvi, Alessandro; Sinagra, Gianfranco

doi:10.1016/s0953-6205(08)60151-x

Cited by 2 publications

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“…The 13 trials included in the meta-analysis were summarized in Table 1 . Seven of the selected cohort studies [ 8 , 13 – 18 ] reported both the early and late outcome events, whereas 5 studies [ 19 – 23 ] only reported the early outcome events and one study [ 24 ] only report the late outcome event. Within the 13 trials, the mean age for non-diabetic participants ranged from 55 to 65 years, and the proportion of men in majority of the studies ranged from 68% to 88%, while 1 study reported mortalities stratified by sex [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

Liu

2015

Med Sci Monit

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BackgroundImpaired admission glucose (AG) is considered to significantly increase risk on both early and late death of the patients with ST-segment elevation myocardial infarction (STEMI), especially for non-diabetic patients; however, some reports contradict the relationship. We therefore conducted a meta-analysis to clarify this issue.Material/MethodsPubMed, EMBASE, Web of Science, and Cochrane Library databases were systematically searched to identify all related prospective cohort studies. The relative risks (RR) with their 95% confidence interval (CI) were pooled quantitatively.ResultsThe pooled RR of early outcome events indicated patients with glucose concentrations ≥6.1–11.1 mmol/L had a 4.38-fold (95% CI, 3.23–5.94) higher early mortality. The pooled RR of late outcome events indicated that the patients with glucose concentrations ≥7.8–11.1 mmol/L had a 1.65-fold (95% CI, 1.33–2.04) higher late mortality based on in-hospital or 30-day survivors.ConclusionsHigh AG may be a helpful prognostic marker of significantly increased risk on early death in non-diabetic patients with STEMI, and has an explicit but prognostic adverse impact on long-term mortality but not early mortality in these patients.

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Section: Resultsmentioning

confidence: 99%

Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

Liu

2015

Med Sci Monit

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Stress hyperglycemia and poor outcomes in patients with ST-elevation myocardial infarction: a systematic review and meta-analysis

Alkatiri,

Qalby,

Mappangara

et al. 2024

Front. Cardiovasc. Med.

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BackgroundHyperglycemia, characterized by elevated blood glucose levels, is frequently observed in patients with acute coronary syndrome, including ST-elevation myocardial infarction (STEMI). There are conflicting sources regarding the relationship between hyperglycemia and outcomes in STEMI patients. We aimed to compile evidence to assess the association between hyperglycemia and adverse outcomes.MethodsWe conducted a comprehensive search for articles on PubMed and Embase using search strategies which yielded 4,061 articles. After full-text screening, 66 articles were included for systematic review, and 62 articles were further selected for meta-analysis.ResultsThe 66 included articles spanned the years 2005–2023. Of these, 45 articles reported admission blood glucose, 13 articles used HbA1c, and 7 articles studied fasting blood glucose. Most studies defined STEMI with primary PCI as their inclusion criteria. Mortality was the most often outcome reported related to hyperglycemia. Overall, 55 (83.3%) studies were at low risk of bias. Both admission and fasting blood glucose were significantly related to short- and long-term mortality after STEMI, with a pooled risk ratio (RR) of 3.02 (95%CI: 2.65–3.45) and 4.47 (95% CI: 2.54–7.87), respectively. HbA1c showed substantial association with long-term mortality (HR 1.69, 95% CI: 1.31–2.18)) with a pooled RR of 1.58 (95% CI 1.26–1.97). In subsequent analyses, admission hyperglycemia was associated with an increased risk of reinfarction (pooled RR 1.69, 95% CI 1.31–2.17), heart failure (pooled RR 1.56, 95% CI: 1.37–1.77), cardiogenic shock (pooled RR 3.68, 95% CI 2.65–5.11), repeat PCI or stent thrombosis (pooled RR 1.99, 95% CI 1.21–3.28), and composite major adverse cardiac and cerebrovascular events (MACCE) (pooled RR 1.99, 95% CI: 1.54–2.58).ConclusionsOur study demonstrated that hyperglycemia has a strong association with poor outcomes after STEMI. Admission and fasting blood glucose are predictors for short-term outcomes, while HbA1c is more appropriate for predicting longer-term outcomes in STEMI patients.Systematic Review RegistrationPROSPERO 2021 (CRD42021292985).

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Impact of Hyperglycemia on Clinical Outcome in Patients Undergoing Percutaneous Coronary Intervention (Pci) for St-Segment Elevation Myocardial Infarction (Stemi)

Cited by 2 publications

References 0 publications

Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis

Stress hyperglycemia and poor outcomes in patients with ST-elevation myocardial infarction: a systematic review and meta-analysis

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