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Glycaemic variability and risk of adverse cardiovascular events in acute coronary syndrome

Lei Zhang1, Feng Li1, Huan-Huan Liu2

  • 1Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.

Diabetes & Vascular Disease Research
|November 7, 2022
PubMed

Insights

Higher glycemic variability (GV) increases cardiovascular risk in acute coronary syndrome (ACS) patients. This meta-analysis confirms that elevated mean amplitude of glycemic excursion (MAGE) and standard deviation (SD) are linked to poor prognosis.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Syndrome

Background:

  • Glycemic variability (GV) is increasingly recognized as a critical factor in cardiovascular health.
  • The precise relationship between different GV metrics and adverse cardiovascular outcomes in acute coronary syndrome (ACS) patients remains unclear.
  • Understanding this link is crucial for improving patient prognosis.

Purpose of the Study:

  • To investigate the association between key GV indexes and adverse cardiovascular events in patients with ACS.
  • To synthesize existing evidence on the prognostic value of GV in ACS.

Main Methods:

  • A systematic literature search was conducted across PubMed, EMBASE, and Web of Science up to June 29, 2022.
  • Meta-analysis was performed on 11 studies involving 3709 ACS patients.
  • The association of mean amplitude of glycemic excursion (MAGE) and standard deviation (SD) with cardiovascular events was evaluated.

Main Results:

  • Higher GV, indicated by both MAGE (RR = 1.76) and SD (RR = 2.14), was significantly associated with an increased risk of adverse cardiovascular events in ACS patients.
  • The findings were statistically significant (p < 0.001) with low heterogeneity for SD (I² = 0%) and moderate heterogeneity for MAGE (I² = 25%).

Conclusions:

  • Elevated glycemic variability is a significant predictor of poor prognosis in patients with acute coronary syndrome.
  • Further well-designed studies are needed to compare various GV indicators and their impact on cardiovascular events in ACS.
Abstract

Keywords:
Glycaemic variabilityacute coronary syndromeadverse cardiovascular eventsmeta-analysis

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