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Stress hyperglycemia and poor outcomes in patients with ST-elevation myocardial infarction: a systematic review and

Abdul Hakim Alkatiri1,2, Nurul Qalby3,4, Idar Mappangara1,2

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

Frontiers in Cardiovascular Medicine
|March 26, 2024
PubMed

Insights

Hyperglycemia (high blood glucose) significantly increases adverse outcomes in ST-elevation myocardial infarction (STEMI) patients. Admission and fasting glucose predict short-term risks, while HbA1c predicts long-term mortality after STEMI.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Hyperglycemia (elevated blood glucose) is common in acute coronary syndrome, particularly ST-elevation myocardial infarction (STEMI).
  • Conflicting data exists on the association between hyperglycemia and STEMI patient outcomes.
  • This study systematically reviewed and meta-analyzed evidence to clarify this relationship.

Approach:

  • A comprehensive literature search was conducted on PubMed and Embase.
  • 66 articles were included for systematic review, with 62 selected for meta-analysis.
  • Studies published between 2005-2023 were analyzed, focusing on various glucose measurements and STEMI outcomes.

Key Points:

  • Both admission and fasting blood glucose levels were significantly associated with increased short- and long-term mortality post-STEMI.
  • HbA1c also showed a substantial association with long-term mortality.
  • Admission hyperglycemia correlated with higher risks of reinfarction, heart failure, cardiogenic shock, repeat PCI, stent thrombosis, and major adverse cardiac and cerebrovascular events (MACCE).

Conclusions:

  • Hyperglycemia is strongly linked to adverse outcomes in STEMI patients.
  • Admission and fasting glucose levels serve as predictors for short-term outcomes.
  • HbA1c is a more appropriate marker for predicting long-term outcomes in STEMI patients.
Abstract

Keywords:
MACCESTEMIadverse outcomeshyperglycemiamortalityrevascularization

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