Impact of diabetes mellitus on mortality and atrial fibrillation in hypertrophic cardiomyopathy: A systematic review and meta-analysis.

IF 5.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-12-15 DOI:10.4239/wjd.v16.i12.110494

Nanush Damarlapally, Roopeessh Vempati, Kesha Mayank Doshi, Manavjot Singh, Kesar Prajapati, Dhruvi Modi, Pooja Singh, Rupak Desai

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引用次数: 0

Abstract

Background: Diabetes mellitus (DM) is a significant risk factor for cardiovascular diseases and can worsen the risk of cardiovascular events among patients with hypertrophic cardiomyopathy (HCM). However, strong evidence is needed to show the impact of DM on all-cause mortality (ACM) and atrial fibrillation (AF), which we explored in this systematic review and meta-analysis.

Aim: To determine the impact of DM on ACM and AF in patients with HCM.

Methods: PubMed, Google Scholar, and EMBASE databases were searched for studies showing the effect of DM on ACM and AF in HCM. A binary random effects model with a 95% confidence interval (CI) was used to pool odds ratios (ORs) for ACM and AF outcomes. Study quality was assessed using the Joanna Briggs Institute's critical appraisal tool and leave-one-out sensitivity analysis. P < 0.05 was considered statistically significant.

Results: Fourteen studies (n = 106138) with a mean age of 61.76 ± 19.84 years and 61.55% males were included in our systematic review; ten studies (n = 102882) were eligible for meta-analysis. In the unadjusted analysis, DM was not significantly associated with ACM (OR = 0.96; 95%CI: 0.43-2.15; P = 0.93). However, after adjustment, DM showed a significant association with higher ACM risk (adjusted OR = 1.37; 95%CI: 1.16-1.61; P < 0.01). DM was significantly associated with AF in both unadjusted (OR = 2.02; 95%CI: 1.14-3.58; P = 0.04) and adjusted analyses (adjusted OR = 2.68; 95%CI: 1.68-4.27; P = 0.01). The Joanna Briggs Institute tool revealed a low risk of bias. Leave-one-out sensitivity analysis, performed by sequentially excluding each study, demonstrated no significant change in the overall effect estimates, indicating the robustness and stability of our results.

Conclusion: DM significantly increased the risk of ACM and AF, highlighting the importance of tighter glycemic control and cardiovascular risk factor modification among patients with HCM.

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糖尿病对肥厚性心肌病患者死亡率和房颤的影响：一项系统回顾和荟萃分析。

背景：糖尿病（DM）是心血管疾病的重要危险因素，可加重肥厚性心肌病（HCM）患者发生心血管事件的风险。然而，需要强有力的证据来证明糖尿病对全因死亡率（ACM）和心房颤动（AF）的影响，我们在本系统综述和荟萃分析中对此进行了探讨。目的：探讨糖尿病对HCM患者ACM和AF的影响。方法：检索PubMed、谷歌Scholar和EMBASE数据库，检索显示DM对HCM患者ACM和AF影响的研究。采用具有95%置信区间（CI）的二元随机效应模型汇总ACM和AF结果的优势比（or）。使用乔安娜布里格斯研究所的关键评估工具和留一敏感性分析来评估研究质量。P < 0.05为差异有统计学意义。结果：14项研究（n = 106138）纳入我们的系统评价，平均年龄为61.76±19.84岁，男性61.55%；10项研究（n = 102882）符合meta分析。在未经调整的分析中，DM与ACM无显著相关（OR = 0.96; 95%CI: 0.43-2.15; P = 0.93）。然而，经校正后，DM与较高的ACM风险有显著相关性（校正OR = 1.37; 95%CI: 1.16-1.61; P < 0.01）。在未调整分析（OR = 2.02; 95%CI: 1.14-3.58; P = 0.04）和调整分析（调整OR = 2.68; 95%CI: 1.68-4.27; P = 0.01）中，DM与AF均显著相关。乔安娜布里格斯研究所的工具显示，偏见的风险很低。通过顺序排除每项研究进行的留一敏感性分析显示，总体效应估计没有显著变化，表明我们的结果具有稳健性和稳定性。结论：糖尿病显著增加了急性动脉粥样硬化（ACM）和心房颤动（AF）的风险，凸显了HCM患者加强血糖控制和心血管危险因素调整的重要性。

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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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.