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首页> 外文期刊>Diabetes care >Newly Discovered Abnormal Glucose Tolerance in Patients With Acute Myocardial Infarction and Cardiovascular Outcomes: A Meta-analysis
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Newly Discovered Abnormal Glucose Tolerance in Patients With Acute Myocardial Infarction and Cardiovascular Outcomes: A Meta-analysis

机译：急性心肌梗死患者和心血管结果的新发现异常葡萄糖耐量：META分析

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BACKGROUND The prevalence of unrecognized abnormal glucose tolerance (AGT) and the incidence of recurrent cardiovascular (CV) events in patients with acute myocardial infarction (MI) has not been systematically evaluated. PURPOSE The purposes of this study were to define the prevalence of newly discovered AGT and examine the risk of recurrent major adverse cardiac events (MACE) and mortality in patients with acute MI. DATA SOURCES Medline, Embase, Cochrane Library, and Google Scholar were searched for relevant articles. STUDY SELECTION Inclusion criteria included prospective studies in patients with acute MI without known history of diabetes; AGT diagnosed using fasting plasma glucose, 2-h oral glucose tolerance test, or HbA(1c); and incidence of MACE and/or all-cause mortality in newly discovered AGT. DATA EXTRACTION Two investigators extracted the data. Pooled prevalence, incidence rate ratios, and hazard ratios (HRs) were calculated using random-effects models. DATA SYNTHESIS In 19 studies (n= 41,509, median follow-up 3.1 years), prevalence of newly discovered AGT was 48.4% (95% CI 40.2-56.6). Prediabetes had a higher mortality risk than normal glucose tolerance (NGT) (HR 1.36 [95% CI 1.13-1.63],P< 0.001) and MACE (1.42 [1.20-1.68],P< 0.001). Newly diagnosed diabetes had higher mortality risk than NGT (1.74 [1.48-2.05],P< 0.001) and MACE (1.54 [1.23-1.93],P< 0.001). LIMITATIONS This is not a meta-analysis of individual patient data. Time-to-event analysis and covariate-adjusted analysis cannot be conducted to examine heterogeneity reliably. Few studies reported CV death and heart failure hospitalizations. CONCLUSIONS Patients with acute MI have a high prevalence of newly discovered AGT. Aggressive risk reduction strategies in this population, especially in those with prediabetes, are warranted.
机译：背景技术尚未系统地评估未被识别的异常葡萄糖耐量（AGT）和复发性心血管（CV）事件的发生率的患病率尚未得到系统评估急性心肌梗死患者（MI）。目的本研究的目的是确定新发现的AGT的患病率，并检查急性MI患者复发性主要不良心脏事件（术士）和死亡率的风险。检测数据源MEDLINE，EMBASE，Cochrane图书馆和Google学者的相关文章。学习选择纳入标准包括急性MI患者的前瞻性研究，没有已知的糖尿病史;使用禁食血浆葡萄糖，2-H口腔葡萄糖耐量试验或HBA（1c）诊断的AGT;和新发现AGT的术穗病和/或全因死亡率的发病率。数据提取两位调查人员提取了数据。使用随机效应模型计算汇总患病率，发病率比和危险比（HRS）。 19研究中的数据合成（n = 41,509，中值随访3.1岁），新发现的AGT患病率为48.4％（95％CI 40.2-56.6）。 Prediabetes的死亡率较高，比正常葡萄糖耐量（NGT）（HR 1.36 [95％CI 1.13-1.63]，P <0.001）和棉签（1.42 [1.20-1.68]，P <0.001）。新诊断的糖尿病的死亡率高于NGT（1.74 [1.48-2.05]，P <0.001）和棉签（1.54 [1.23-1.93]，P <0.001）。限制这不是个体患者数据的元分析。不能进行时间​​ - 进一步的分析和调整调整分析以可靠地检查异质性。少数研究报告了CV死亡和心力衰竭住院治疗。结论急性MI患者具有新发现的AGT患病率。有必要保证本人群中的侵略性风险策略，特别是在与前驱脂肪的人口中。

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