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Acute Hyperglycemia and Its Impact on Mortality of Acute Coronary Syndrome Patients: A Systematic Review

Ravi K Pandey1, Bo B Lwin1, Apoorva Vashishta1

  • 1Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Cureus
|September 9, 2024
PubMed

Insights

Acute hyperglycemia, or stress hyperglycemia, is linked to increased mortality in acute coronary syndrome (ACS) patients. This review confirms that stress hyperglycemia ratio (SHR), admission blood glucose (ABG), and fasting plasma glucose (FPG) predict both short- and long-term outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Research

Background:

  • Acute hyperglycemia is common in acute coronary syndrome (ACS) patients.
  • Existing evidence suggests a link between acute hyperglycemia and mortality in ACS, but requires further substantiation.
  • The precise definition and prognostic value of acute hyperglycemia in ACS remain areas for investigation.

Purpose of the Study:

  • To systematically review recent literature (2014-2024) on the association between acute hyperglycemia and mortality in ACS patients.
  • To evaluate the predictive value of different hyperglycemia metrics, including stress hyperglycemia ratio (SHR), admission blood glucose (ABG), and fasting plasma glucose (FPG).
  • To synthesize current evidence and identify gaps for future research regarding hyperglycemia in ACS.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Google Scholar, and Science Direct.
  • Initial screening of 1056 articles yielded 919 for title/abstract review, followed by full-text screening of 169.
  • Twenty-one relevant studies (16 observational, 2 systematic reviews/meta-analyses, 3 reviews) were included after quality assessment and eligibility criteria application.

Main Results:

  • A consistent positive correlation was observed between acute hyperglycemia and both short-term (in-hospital, <30 days) and long-term (>30 days) mortality in ACS patients.
  • The reviewed studies utilized SHR, ABG, and FPG to quantify acute hyperglycemia.
  • All three assessed parameters (SHR, ABG, FPG) demonstrated predictive value for short- and long-term mortality in ACS.

Conclusions:

  • Acute hyperglycemia, as measured by SHR, ABG, or FPG, is a significant predictor of mortality in patients with acute coronary syndrome.
  • The findings support the clinical relevance of monitoring and managing hyperglycemia in ACS.
  • Further research is warranted to establish precise cutoff values for defining acute hyperglycemia in diabetic ACS patients.

Keywords:
acute hyperglycemiaadmission hyperglycemiaadverse outcomeheart attackmortalitynstemiprognosisstemistress hyperglycemiaunstable angina

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