Admission Glucose and Risk of Early Death in Non-Diabetic Patients with ST-Segment Elevation Myocardial Infarction: A Meta-Analysis
Cheng-jin Zhao, Zhen-xuan Hao, Rong Liu, Yang Liu
Department of Emergency, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China (mainland)
Med Sci Monit 2015; 21:1387-1394
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 AND 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.
Keywords: Blood Glucose - analysis, Electrocardiography, Hospital Mortality, Hyperglycemia - mortality, Myocardial Infarction - therapy, Patient Admission, Prognosis, Prospective Studies, Risk, Survival Analysis, Time Factors