Impact of diabetes on outcomes of cardiogenic shock: A systematic review and meta-analysis

Abstract

To provide synthesized evidence on the association of diabetes with clinical outcomes of patients with acute myocardial infarction (AMI) and associated cardiogenic shock (CS). We analyzed observational studies on patients with AMI and CS, identified through a systematic search using PubMed and Scopus databases. The main outcome was mortality and other outcomes of interest were risk of major bleeding, re-infarction, cerebrovascular adverse events, and need for revascularization. We conducted the meta-analysis with data from 15 studies. Compared to patients without diabetes, those with diabetes had an increased risk of in-hospital mortality (OR, 1.34; 95% CI, 1.17–1.54) and cerebrovascular complications (OR, 1.28; 95% CI, 1.11–1.48). We found similar risk of major bleeding (OR, 0.68; 95% CI, 0.43–1.09), re-infarction (OR, 0.98; 95% CI, 0.48–1.98) and need for re-vascularization (OR, 0.96; 95% CI, 0.75–1.22) as well as hospital stay lengths (in days) (WMD 0.00; 95% CI, −0.27–0.28; n = 4; I2 = 99.7%) in the two groups of patients. Patients with diabetes, acute MI and associated cardiogenic shock have increased risks of mortality and adverse cerebrovascular events than those without diabetes.