Admission glucose and risk of early death in non-diabetic patients with ST-segment elevation myocardial infarction: a meta-analysis

Med Sci Monit. 2015 May 14:21:1387-94. doi: 10.12659/MSM.894249.

Abstract

Background: Impaired admission glucose (AG) is considered to significantly increase risk on both early and late death of the patients with ST-segment elevation myocardial infarction (STEMI), especially for non-diabetic patients; however, some reports contradict the relationship. We therefore conducted a meta-analysis to clarify this issue.

Material/methods: PubMed, EMBASE, Web of Science, and Cochrane Library databases were systematically searched to identify all related prospective cohort studies. The relative risks (RR) with their 95% confidence interval (CI) were pooled quantitatively.

Results: The pooled RR of early outcome events indicated patients with glucose concentrations ≥6.1-11.1 mmol/L had a 4.38-fold (95% CI, 3.23-5.94) higher early mortality. The pooled RR of late outcome events indicated that the patients with glucose concentrations ≥7.8-11.1 mmol/L had a 1.65-fold (95% CI, 1.33-2.04) higher late mortality based on in-hospital or 30-day survivors.

Conclusions: High AG may be a helpful prognostic marker of significantly increased risk on early death in non-diabetic patients with STEMI, and has an explicit but prognostic adverse impact on long-term mortality but not early mortality in these patients.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Glucose / analysis*
  • Electrocardiography
  • Female
  • Hospital Mortality
  • Humans
  • Hyperglycemia / etiology
  • Hyperglycemia / mortality
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / complications
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy
  • Patient Admission
  • Prognosis
  • Prospective Studies
  • Risk
  • Survival Analysis
  • Time Factors

Substances

  • Blood Glucose