A Systematic Review Evaluating the Impact of Glycemic Control on Mortality and Major Adverse Cardiac Events in Type 2...

Acute coronary syndrome (ACS) is a global cause of mortality and morbidity, specifically among type 2 diabetes mellitus (T2DM) patients. Patients with hyperglycemia had unfavorable outcomes after acute myocardial infarction (AMI), with a high rate of mortality ranging between 1.5 and 2.5 fold, along with a high incidence of major adverse cardiovascular events (MACEs), compared to normoglycemic patients. Acute hyperglycemia and chronic glycemic exposure are indicated by HbA1c and are related to poor cardiovascular outcomes, which were followed by ACS. The review assessed the current evidence on the effect of the glycemic status and the strategies to control the glycemic level among T2DM patients presenting with ACS. This was a systematic review that was conducted according to the PRISMA guidelines. PubMed/MEDLINE, Web of Science, and Scopus were used as search engines to get relevant studies for the review. Eligible studies included those with ACS patients, and the glycemic status was investigated in association with the clinical outcome, such as mortality and MACEs. The Newcastle-Ottawa Scale was used to assess the quality of the study. Twelve studies included 85,000 patients; the admission of hyperglycemia was strongly related to the worst outcomes after AMI. The all-cause mortality ranges from 9.0% to 25.1%, while the variation in hospital mortality ranges between 1.9% and 9.8%. Various studies have included the high risk associated with high glucose levels. Hyperglycemia was associated with a high rate of adverse cardiac events, including heart failure, cardiogenic shock, and arrhythmias. The study concluded that poor glycemic control increases the rate of mortality during admission, and the adverse cardiac events are also enhanced among type 2 diabetes patients with ACS.