Abstract
Introduction:
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.
Methods
Using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level”, we searched PubMed, Web of Science, and Scopus for eligible articles that should undergo the screening process to determine its ability to be included in our study. Using Review Manager version 5.4 software, we conducted the meta-analysis of the included studies by pooling the mean difference in continuous variables, number and total of dichotomous variables to measure the odds ratio (OR), and generic inverse variance of OR or hazard ratio (HR) as they were reported in the included studies.
Results
The difference between the diabetes and non-diabetes patients regarding blood glucose level was found to be statistically significant with SMD of 1.39 (95%CI: 1.12, 1.66, p < 0.00001). Hyperglycemia in diabetic patients was statistically significant associated with mortality with HR of 1.92 (95%CI: 1.45, 2.55, p < 0.00001) and OR of 1.76 (95%CI: 1.15, 2.7, p = 0.01). In non-diabetic patients admitted with AMI, hyperglycemia was statistically significant associated with mortality with HR of 1.56 (95%CI: 1.31, 1.86, p < 0.00001), and OR of 2.89 (95%CI: 2.47, 3.39, p < 0.00001). Moreover, hyperglycemia in diabetic patients admitted with AMI was statistically significant associated with occurrence of MACE with HR of 1.9 (95%CI: 1.19, 3.03, p = 0.007) and hyperglycemia in non-diabetic AMI patients was statistically significant associated with occurrence of MACE with HR of 1.6 (95%CI: 1.15, 2.23, p = 0.006).
Conclusion
Hyperglycemia in AMI patients is a predictor of worse outcomes including MACE, and mortality whether these patients are diabetic or not. Some factors act as predictors for mortality in these patients including older age, higher glucose levels on admission, and high Killip class.