Hyperglycemia as a risk factor for in-hospital mortality in myocardial infarction

Ciro Barrantes-Alarcón, Rosalia Fernández-Coronado, Adriel Olortegui-Yzu
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Abstract

Introduction: Myocardial infarction continues with high mortality rates, from 4.6% to 13.1%. There are predictive risk stratification models, such as the Grace Score, which does not include glycemia as a variable. Patients hospitalized for myocardial infarction with hyperglycemia on admission may have higher mortality, in ST elevated and non-elevated infarcts. Objectives: The objective of this review is to identify and systematize the evidence on hyperglycemia on admission as a biomarker of mortality and heart failure in acute myocardial infarction. Materials and Methods: The search was carried out in the MEDLINE database including the MeSH terms hyperglycemia and hospital mortality or heart failure in myocardial infarction, selecting 12 articles. Results: Hospital mortality was calculated in 11 articles, in 9 of them a significant association was found between hyperglycemia and hospital mortality, both in the bivariate and multivariate analysis, and in 2 articles this association was not demonstrated. For in-hospital mortality, the results of 11 articles included in this review were synthesized. The frequency of occurrence of heart failure was determined in 11 articles, finding a higher frequency in 9 of them. For in-hospital mortality, the results of 11 articles included in this review were synthesized and analyzed, in 8 the analysis was performed in non-diabetics, obtaining OR: 4.15, IC 95% (2.853-6.035), in 3 for diabetics obtaining OR 2.365 IC 95% (1.778- 3,146) and in 6 for the total population finding OR 3,314 (2,910-3,774). Conclusions: Hyperglycemia on admission is associated with increased mortality and frequency of occurrence of heart failure during hospitalization for myocardial infarction, with evidence of moderate quality.
高血糖是心肌梗死住院死亡率的一个风险因素
导言心肌梗死的死亡率一直居高不下,从 4.6% 到 13.1%。有一些预测性风险分层模型,如格雷斯评分(Grace Score),其中不包括血糖这一变量。入院时血糖过高的心肌梗死患者死亡率可能更高,ST段抬高和非抬高的心肌梗死患者均是如此。目的:本综述旨在确定并系统整理有关入院时高血糖作为急性心肌梗死死亡率和心力衰竭生物标志物的证据。材料与方法:在 MEDLINE 数据库中以高血糖和心肌梗死住院死亡率或心力衰竭为 MeSH 关键词进行检索,共筛选出 12 篇文章。结果:11篇文章计算了住院死亡率,其中9篇文章在二元和多元分析中发现高血糖与住院死亡率之间存在显著关联,2篇文章未发现这种关联。关于院内死亡率,本综述综合了 11 篇文章的结果。11 篇文章对心力衰竭的发生频率进行了测定,发现其中 9 篇文章的发生频率较高。就院内死亡率而言,对本综述收录的11篇文章的结果进行了综合分析,其中8篇文章对非糖尿病患者进行了分析,得出OR:4.15,IC 95% (2.853-6.035);3 篇针对糖尿病患者,OR 为 2.365,IC 95% (1.778-3,146);6 篇针对总人口,OR 为 3,314 (2,910-3,774)。结论是入院时的高血糖与心肌梗死住院期间死亡率和心力衰竭发生率的增加有关,证据质量中等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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62
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12 weeks
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