Newly diagnosed abnormal glucose tolerance determines post-MI prognosis in patients with hospital related hyperglycaemia but without known diabetes

Chattopadhyay, Sudipta; George, Anish; John, Joseph; Sathyapalan, Thozhukat

doi:10.1016/j.jdiacomp.2019.107518

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…The database searching process yielded a total of 2157 articles with 761 duplicates so a total of 1396 articles entered the title and abstract screening. A total of 1369 articles were excluded and then 27 articles were screened by full-text to yield a total of 19 articles (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) for the meta-analysis. (Fig.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients

Alawaji,

Musslem,

Alshalahi

et al. 2024

Preprint

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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.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients

Alawaji,

Musslem,

Alshalahi

et al. 2024

Preprint

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“…In patients without diabetes, admission blood glucose alone without HbA1c values to test for undiagnosed diabetes or prediabetes and without post-discharge tests to assess the glycaemic state after the drop of stress during hospital admission, the meaning and interpretation of admission hyperglycaemia in clinical practice is difficult. [46][47][48][49] We cannot exclude the possibility that the outcome in the group without diabetes was driven by pre-diabetes or undiagnosed diabetes. Furthermore, there is a lack of information on the effect of in-hospital treatment regarding hyperglycaemia and hypoglycaemia, and how glucose levels during hospital stay affected adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry

et al. 2021

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Study objectivesTo investigate the association between admission blood glucose levels and 28-day mortality as well as in-hospital complications in older patients with incident acute myocardial infarction (AMI) undergoing modern treatment.MethodsFrom a German population-based regional MI registry, 5530 patients (2016 women), aged 65–84 years, hospitalised with an incident AMI between 1 January 2009 and 31 December 2016 were included in the study. Multivariable logistic regression models were used to assess the associations between admission blood glucose and 28-day mortality as well as in-hospital complications after AMI. Analyses stratified according to age, diabetes and type of infarction (ST-elevation MI (STEMI)/non-STEMI) were conducted.ResultsThe adjusted ORs for the association between admission blood glucose and 28-day mortality in young-old (65–74 years) and old (75–84 years) patients with AMI were 1.40 (95% CI: 1.21 to 1.62) and 1.21 (95% CI: 0.98 to 1.50) per 1 SD increase in admission blood glucose, respectively. Furthermore, higher admission blood glucose was related to case fatality irrespective of the diabetes status and type of infarction only in the under-75 group. For the patients aged 75–84 years, it was only true for those without diabetes and STEMI. Admission blood glucose was also associated with major cardiac complications in both age groups.ConclusionAdmission blood glucose was significantly associated with 28-day case fatality in patients with AMI aged 65–74 years but not 75–84 years; furthermore, in both age groups there was an increased risk of major complications. It seems that admission glucose may play a rather minor role in terms of case fatality in higher aged patients with AMI.

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“…and 22% higher risk of CVD and CHD, respectively. Moreover, finding of some studies showed that IGT was associated with worse post MI prognosis [9,22] while some showed no significant risk [26] and study by George et al [23] revealed that IGT is associated with higher risk of MACE but not hard CVD outcomes. The findings of our study however, showed that the risk of CVD/CHD and the related hard outcomes does not increase among those with IGT; in line with other studies conducted among low risk population with prevalent CAD [8,34].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the newly diagnosed diabetes using 2 h-PCPG criteria, most studies showed that newly diagnosed diabetes [21,26] or AGT (newly diagnosed diabetes using 2 h-PCPG definition plus IGT) are independently associated with higher risk of different cardiovascular outcomes [9][10][11][24][25][26]. In the current study however, when using 2 h-PCPG criteria, a moderate higher risk of hard CHD 2.02 [(0.91-4.47), P = 0.08] was seen among those with newly diagnosed diabetes.…”

Section: Discussionmentioning

confidence: 99%

Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based study

Kabootari

Asgari

Ghavam

et al. 2020

Preprint

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Background: To assess the association between fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2h-PCPG) as continuous or categorical variables with risk of recurrent cardiovascular disease (CVD) and incident diabetes among subjects with history of previous CVD. Methods: In a prospective population-based cohort, a total of 335 Iranians aged ≥30 years, with history of CVD and free of known diabetes were included. Prediabetes was defined as impaired fasting glucose (IFG) according to the criteria of the American Diabetes Association (ADA) [IFG-ADA; FPG: 5.6-6.9 mmol/L], the World Health Organization (WHO) expert group (IFG-WHO; FPG: 6.1-6.9 mmol/L) and impaired glucose tolerance [IGT: 2h-PCPG: 7.8-11.0 mmol/L]. Cox’s proportional hazard models adjusted for traditional risk factors were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different glucose intolerance for outcomes of interest. Results: During a median follow-up of 15.8 (IQR, 10.7-16.5) years, 178 CVD (hard event including death, myocardial infarction and stroke=69) events occurred. Regarding FPG, only IFG-ADA was associated with significant higher risk of hard CVD in the fully adjusted model (HR, 1.73, 95% CI: 1.04-2.89). Moreover, newly diagnosed diabetes (FPG≥7 mmol/L) was an independent risk of CVD (2.11: 1.22-3.66). Focusing on 2h-PCPG, subjects with newly diagnosed diabetes (2h-PCPG ≥ 11.1 mmol/L) had moderately increased risk of hard coronary heart disease (2.02:0.91-4.47, P=0.08). The multivariate HRs (95% CI) associated with 1 SD increase in FPG and 2h-PCPG was 1.16 (1.01–1.33) and 1.19 (1.02–1.38) for CVD, respectively. Among population free of diabetes at baseline (n=270), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes in multivariate analysis (all HRs > 4, P< 0.001); significant associations were also found for FPG and 2h-PCPG as continuous variables (all HRs for 1-SD increase > 2, all P < 0.001). Conclusions: Among subjects with stable CVD, both FPG and 2h-PCPG as continuous variables was associated with higher risk of recurrent CVD. However, only IFG-ADA was independent predictor of hard CVD events. Also, newly diagnosed diabetes, using FPG criteria, was associated with a significant risk of CVD. IFG-ADA, IFG-WHO and IGT were all significant predictors of incident diabetes.

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Newly diagnosed abnormal glucose tolerance determines post-MI prognosis in patients with hospital related hyperglycaemia but without known diabetes

Cited by 7 publications

References 38 publications

A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients

A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients

Admission glucose level and short-term mortality in older patients with acute myocardial infarction: results from the KORA Myocardial Infarction Registry

Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based study

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