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Abstract：
BACKGROUND: Previous studies evaluating the association between prediabetes the prognosis of patients with acute myocardial infarction (AMI) showed inconsistent results. The aim of the meta-analysis was to compare the long-term incidence of major adverse cardiovascular events (MACEs) between AMI patients with prediabetes and normoglycemia.
METHODS: Relevant prospective cohort studies were obtained by searching Medline, Web of Science, and Embase databases. Only studies with follow-up duration of at least one year were included. A random-effects model was utilized to pool the results by incorporating the influence of heterogeneity.
RESULTS: Twelve studies with 6972 patients with AMI were included. Among them, 2998 were with prediabetes and 3974 were with normoglycemia. During a mean follow-up of 52.6 months, 2100 patients developed MACEs. Compared to those with normoglycemia, AMI patients with prediabetes were associated with a higher incidence of MACEs (risk ratio [RR]: 1.30, 95% confidence interval: 1.07 to 1.58, p = 0.008; I2 = 67%). Subgroup analysis showed a stronger association between prediabetes and MACEs in studies of patients with mean age ≥ 60 years compared to < 60 years (RR: 1.66 versus 1.10, p for subgroup difference = 0.04), with proportion of men < 75% compared to ≥ 75% (RR: 1.87 versus 1.08, p for subgroup difference = 0.01), and in prediabetes evaluated at or after discharge compared to that evaluated within three days of AMI onset (RR: 1.39 versus 0.78, p for subgroup difference = 0.01).
CONCLUSIONS: Prediabetes may be associated with a higher risk of MACEs in patients with AMI.
METHODS: Relevant prospective cohort studies were obtained by searching Medline, Web of Science, and Embase databases. Only studies with follow-up duration of at least one year were included. A random-effects model was utilized to pool the results by incorporating the influence of heterogeneity.
RESULTS: Twelve studies with 6972 patients with AMI were included. Among them, 2998 were with prediabetes and 3974 were with normoglycemia. During a mean follow-up of 52.6 months, 2100 patients developed MACEs. Compared to those with normoglycemia, AMI patients with prediabetes were associated with a higher incidence of MACEs (risk ratio [RR]: 1.30, 95% confidence interval: 1.07 to 1.58, p = 0.008; I2 = 67%). Subgroup analysis showed a stronger association between prediabetes and MACEs in studies of patients with mean age ≥ 60 years compared to < 60 years (RR: 1.66 versus 1.10, p for subgroup difference = 0.04), with proportion of men < 75% compared to ≥ 75% (RR: 1.87 versus 1.08, p for subgroup difference = 0.01), and in prediabetes evaluated at or after discharge compared to that evaluated within three days of AMI onset (RR: 1.39 versus 0.78, p for subgroup difference = 0.01).
CONCLUSIONS: Prediabetes may be associated with a higher risk of MACEs in patients with AMI.
摘要：
背景：先前评估糖尿病前期与急性心肌梗死（AMI）患者预后之间关系的研究显示结果不一致。荟萃分析的目的是比较糖尿病前期和血糖正常的AMI患者之间主要不良心血管事件（MACE）的长期发生率。
方法：通过搜索Medline获得相关的前瞻性队列研究，WebofScience,和Embase数据库。仅包括随访时间至少为一年的研究。利用随机效应模型通过纳入异质性的影响来汇集结果。
结果：纳入了12项研究，纳入6972例AMI患者。其中,2998人患有前驱糖尿病，3974人血糖正常。在平均52.6个月的随访中，2100例患者出现MACE。与血糖正常的人相比，患有糖尿病前期的AMI患者与较高的MACEs发生率相关（风险比[RR]：1.30，95％置信区间：1.07至1.58，p=0.008；I2=67％）。亚组分析显示，在平均年龄≥60岁的患者的研究中，糖尿病前期与MACE之间的关联更强（RR：1.66对1.10，亚组差异p=0.04），男性比例<75％，而男性比例≥75％（RR：1.87对1.08，亚组差异p=0.01），在出院时或出院后评估的糖尿病前期与AMI发病后三天内评估的相比（RR：1.39对0.78，亚组差异p=0.01）。
结论：在AMI患者中，糖尿病前期可能与较高的MACEs风险相关。
方法：通过搜索Medline获得相关的前瞻性队列研究，WebofScience,和Embase数据库。仅包括随访时间至少为一年的研究。利用随机效应模型通过纳入异质性的影响来汇集结果。
结果：纳入了12项研究，纳入6972例AMI患者。其中,2998人患有前驱糖尿病，3974人血糖正常。在平均52.6个月的随访中，2100例患者出现MACE。与血糖正常的人相比，患有糖尿病前期的AMI患者与较高的MACEs发生率相关（风险比[RR]：1.30，95％置信区间：1.07至1.58，p=0.008；I2=67％）。亚组分析显示，在平均年龄≥60岁的患者的研究中，糖尿病前期与MACE之间的关联更强（RR：1.66对1.10，亚组差异p=0.04），男性比例<75％，而男性比例≥75％（RR：1.87对1.08，亚组差异p=0.01），在出院时或出院后评估的糖尿病前期与AMI发病后三天内评估的相比（RR：1.39对0.78，亚组差异p=0.01）。
结论：在AMI患者中，糖尿病前期可能与较高的MACEs风险相关。
