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In-hospital fasting hyperglycemia and increased risk of mortality after acute coronary syndrome: a systematic overview and meta-analysis

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Abstract

Background

Several studies noted that increased fasting blood glucose in hospital is associated with increasing mortality of acute coronary syndrome (ACS). We conducted a meta-analysis to assess the risk of mortality after ACS in patients who had fasting hyperglycemia (FH) in hospital.

Methods

We conducted searches on PubMed, Cochrane Library, Web of Science, and Embase for relevant studies published before August 31, 2019. We pooled odds ratios (OR) from individual studies using a random effects model. Data abstraction was conducted by two independent reviewers, and the meta-analysis was performed using Review Manager version 5.3.

Results

Eight studies were included into our research. Patients with FH showed a 3.09-fold (OR 3.09, CI 2.64–3.61; p < 0.00001) increased mortality of patients during admission compared with those who had normal fasting blood glucose (FBG). A statistically significant difference in post hospitalization mortality between patients with and without in-hospital FH was also detected (OR 3.40, CI 2.80–4.14; p < 0.00001).

Conclusions

The available evidence suggests that in-hospital FH could increase the risk of in-hospital and out-of-hospital (30-day and long-term) mortalities after ACS.

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Abbreviations

ACS:

acute coronary syndrome

OR:

odds ratios

FH:

fasting hyperglycemia

FBG:

fasting blood glucose

STEMI:

ST elevation myocardial infarction

NSTEMI:

non-ST elevated myocardial infarction

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Funding

This work was partly supported by Suzhou Wujiang District Science and Education Xingwei Project (wwk201707) and Second Affiliated Hospital of Soochow University Science Foundation (SDFEYQN1711).

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Author notes

  1. Xuehua Jiao and Heming Guo contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, The First People’s Hospital of Wujiang District, Suzhou, 215000, Jiangsu, China

    Xuehua Jiao & Xueyan Yin

  2. Department of Endocrinology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China

    Heming Guo

  3. Department of Endocrinology, Yongding Hospital, Suzhou, 215000, Jiangsu, China

    Guodong Zhang

  4. Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China

    Hui Li

  5. Department of Endocrinology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China

    Yiting Chen

Authors
  1. Xuehua Jiao
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  2. Heming Guo
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  3. Guodong Zhang
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  4. Xueyan Yin
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  5. Hui Li
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Contributions

Hui Li and Chen Yiting conceived and designed the study. Xuehua Jiao, Heming Guo, Guodong Zhang, and Xueyan Yin collected and analyzed the data. Xuehua Jiao and Heming Guo wrote the manuscript. All authors read and approved the manuscript.

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Correspondence to Hui Li or Yiting Chen.

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Jiao, X., Guo, H., Zhang, G. et al. In-hospital fasting hyperglycemia and increased risk of mortality after acute coronary syndrome: a systematic overview and meta-analysis. Int J Diabetes Dev Ctries 41, 536–542 (2021). https://doi.org/10.1007/s13410-020-00850-3

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  • DOI: https://doi.org/10.1007/s13410-020-00850-3

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