高血糖对糖尿病和非糖尿病患者急性心肌梗死入院影响的系统回顾和荟萃分析

IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Reem Alawaji, Mohammed Musslem, Emtenan Alshalahi, Abdulaziz Alanzan, Albarra Sufyani, Maram Alhati, Alhanouf Almutairi, Mahdi Alqaffas, Batool Alattas, Adhari Alselmi
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引用次数: 0

摘要

关于糖尿病与急性心肌梗死(AMI)患者高血糖的预后意义之间的潜在关系,目前仍存在争议。因此,我们在本研究中旨在证明高血糖对急性心肌梗死患者不同预后的影响,无论患者是否患有糖尿病。我们使用以下搜索策略在 PubMed、Web of Science 和 Scopus 上进行了搜索:"糖尿病 "或 "糖尿病 "和 "急性心肌梗死 "或 "AMI "和 "高血糖 "或 "血糖水平",以找到符合条件的文章,这些文章需要经过筛选才能纳入我们的研究。我们使用 Review Manager 5.4 版软件对来自日本、德国、中国、英国和其他国家的 19 项纳入研究进行了荟萃分析,汇总了连续变量的平均差、二分变量的数量和总和,以计算几率比(OR),以及纳入研究中报告的 OR 或危险比(HR)的通用反方差。参与者的平均年龄在 56.3 岁至 72.3 岁之间。研究发现,糖尿病患者和非糖尿病患者的血糖水平差异具有统计学意义,SMD 为 1.39(95%CI:1.12,1.66,P < 0.00001)。在糖尿病患者中,高血糖与死亡率有显著统计学相关性,HR 为 1.92(95% CI:1.45,2.55,p < 0.00001),OR 为 1.76(95% CI:1.15,2.7,p = 0.01)。在收治的非糖尿病急性心肌梗死患者中,高血糖与死亡率有显著统计学相关性,HR 为 1.56(95% CI:1.31,1.86,p < 0.00001),OR 为 2.89(95% CI:2.47,3.39,p < 0.00001)。据统计,患有糖尿病的急性心肌梗死患者更有可能发生重大不良心血管事件(MACE)(HR = 1.9;95% CI:1.19-3.03;P = 0.007)。据统计,非糖尿病急性心肌梗死患者发生 MACE 的几率也更高(HR = 1.6;95% CI:1.15-2.23;P = 0.006)。无论患者是否患有糖尿病,急性心肌梗死患者的高血糖都会导致不良预后,包括MACE和死亡率。在这些患者中,一些因素可预测死亡率,包括年龄较大、入院时血糖水平较高以及 Killip 分级较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A systematic review and meta-analysis of the effect of hyperglycemia on admission for acute myocardial infarction in diabetic and non-diabetic patients
Regarding a potential relationship between diabetes and the prognostic significance of hyperglycemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycemia on different outcomes in AMI patients, whether they are diabetic or not. We searched PubMed, Web of Science, and Scopus using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level” to find eligible articles that needed to go through the screening process for inclusion in our study. We conducted a meta-analysis of 19 included studies from Japan, Germany, China, the United Kingdom, and others using Review Manager version 5.4 software, pooling the mean difference in continuous variables, the number and total of dichotomous variables to measure the odds ratio (OR), and the generic inverse variance of OR or hazard ratio (HR) as reported in the included studies. The mean age of the participants ranged from 56.3 to 72.3 years old. The difference in blood glucose levels between diabetes and non-diabetes patients was found to be statistically significant, with an SMD of 1.39 (95%CI: 1.12, 1.66, p < 0.00001). In diabetic patients, hyperglycemia was statistically significantly associated with mortality, with a HR of 1.92 (95% CI: 1.45, 2.55, p < 0.00001) and an OR of 1.76 (95% CI: 1.15, 2.7, p = 0.01). In non-diabetic patients admitted with AMI, hyperglycemia was statistically significantly associated with mortality, with a HR of 1.56 (95% CI: 1.31, 1.86, p < 0.00001) and an OR of 2.89 (95% CI: 2.47, 3.39, p < 0.00001). AMI patients who were diabetic were statistically more likely to have a major adverse cardiovascular event (MACE) (HR = 1.9; 95% CI: 1.19–3.03; p = 0.007). AMI patients who were not diabetic were also statistically more likely to have a MACE (HR = 1.6; 95% CI: 1.15–2.23, p = 0.006). Hyperglycemia in AMI patients is a predictor of worse outcomes, including MACE and mortality, regardless of whether these patients are diabetic or not. In these patients, some factors act as predictors of mortality, including older age, higher glucose levels on admission, and a high Killip class.
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来源期刊
Diabetology & Metabolic Syndrome
Diabetology & Metabolic Syndrome ENDOCRINOLOGY & METABOLISM-
CiteScore
6.20
自引率
0.00%
发文量
170
审稿时长
7.5 months
期刊介绍: Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome. By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.
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