Stella Pak1, Yan Yatsynovich2, John-Phillip Markovic2. 1. Department of Medicine, Kettering Medical Center, Kettering, OH, 45429, USA. Electronic address: Stella.Pak@rockets.utoledo.edu. 2. Department of Medicine, Kettering Medical Center, Kettering, OH, 45429, USA.
Abstract
AIMS: The aim was to compare the size of the myocardial infarct detected on cardiovascular magnetic resonance imaging (CMR) between patients with and without admission hyperglycemia after acute myocardial infarction (AMI). METHODS: Studies were identified by searching on MEDLINE, EMBASE, and CINAHL databases. A systematic review was conducted by two independent reviewers. Microvascular obstruction (MVO) and late gadolinium enhancement (LGE) were pooled from available studies to calculate the standardized mean difference (SMD) in post-MI infarct size between patients with and without hyperglycemia at admission. RESULTS: The systematic review yielded 5 studies with MCR data for patients with and without admission hyperglycemia. The total number of patients included in this study was 911. A statistically significant difference was detected in MVO between patients with and without admission hyperglycemia (SMD = 0.79, 95% CI: 0.11, 1.47, P < 0.00001). The difference in LGE between patients with and without admission hyperglycemia was also significant (SMD = 0.57, 95% CI: -0.04, 1.18, P < 0.00001). CONCLUSION: The main finding of our analyses is that the size of myocardial infarct detected on CMR is positively correlated to admission hyperglycemia in patients with AMI. The clinical importance of this study lies in the accurate assessment of prognostic value of admission glucose, which would help clinicians in risk stratification and treatment decision-making.
AIMS: The aim was to compare the size of the myocardial infarct detected on cardiovascular magnetic resonance imaging (CMR) between patients with and without admission hyperglycemia after acute myocardial infarction (AMI). METHODS: Studies were identified by searching on MEDLINE, EMBASE, and CINAHL databases. A systematic review was conducted by two independent reviewers. Microvascular obstruction (MVO) and late gadolinium enhancement (LGE) were pooled from available studies to calculate the standardized mean difference (SMD) in post-MI infarct size between patients with and without hyperglycemia at admission. RESULTS: The systematic review yielded 5 studies with MCR data for patients with and without admission hyperglycemia. The total number of patients included in this study was 911. A statistically significant difference was detected in MVO between patients with and without admission hyperglycemia (SMD = 0.79, 95% CI: 0.11, 1.47, P < 0.00001). The difference in LGE between patients with and without admission hyperglycemia was also significant (SMD = 0.57, 95% CI: -0.04, 1.18, P < 0.00001). CONCLUSION: The main finding of our analyses is that the size of myocardial infarct detected on CMR is positively correlated to admission hyperglycemia in patients with AMI. The clinical importance of this study lies in the accurate assessment of prognostic value of admission glucose, which would help clinicians in risk stratification and treatment decision-making.