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. 2022 Apr 12;38(3):307-315.
doi: 10.1002/joa3.12708. eCollection 2022 Jun.

Admission hyperglycemia in acute myocardial infarction is associated with an increased risk of arrhythmias: A systematic review and meta-analysis

Angkawipa Trongtorsak  1 , Jakrin Kewcharoen  2 , Sittinun Thangjui  3 , Maria Adriana Yanez-Bello  1 , Mina Sous  1 , Paritosh Prasai  1 , Leenhapong Navaravong  4
Affiliations

Admission hyperglycemia in acute myocardial infarction is associated with an increased risk of arrhythmias: A systematic review and meta-analysis

Angkawipa Trongtorsak et al. J Arrhythm. .

Abstract

Background: Admission hyperglycemia (AH) has shown to be associated with higher mortality rates in acute myocardial infarction (AMI). Malignant arrhythmia is one of the causes of death in AMI; however, it is unclear whether AH is associated with an increased arrhythmia risk. We conducted this systematic review and meta-analysis to assess the association between AH and arrhythmias in AMI.

Methods: We searched MEDLINE, and Embase databases from inception to September 2021 to identify studies that compared arrhythmia rates between AMI patients with AH and those without. Arrhythmias of interest included ventricular tachyarrhythmias (VA), atrial fibrillation (AF), and atrioventricular block.

Results: Thirteen cohort studies with a total of 12,898 patients were included. AH was associated with a higher risk of overall arrhythmias (18% vs 10.3%, pooled odds ratio [OR] = 1.89, 95% confidence interval [CI]: 1.39-2.56, P < .001), VA (16.4% vs 11.1%, pooled OR = 1.56, 95% CI: 1.11-2.18, P = .01), and new onset AF (17.8% vs 6.4%, pooled OR = 2.13, 95% CI: 1.4-3.25, P < .0010. Subgroup analysis of diabetes status regarding overall arrhythmias showed that the increased risk of arrhythmias in the AH group was consistent in both patients with a history of diabetes (18% vs 12.5%, pooled OR = 2.33, 95%CI: 1.2-4.52, P = .004) and without (15.7%. vs 9% pooled OR = 1.35, 95% CI: 1.1-1.66, P = .013).

Conclusion: Admission hyperglycemia in AMI was associated with the increased risk of arrhythmias, regardless of history of diabetes mellitus.

Keywords: acute myocardial infarction; arrhythmia; hyperglycemia.

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Conflict of interest statement

All authors have no competing interests.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram illustrating the study selection process
FIGURE 2
FIGURE 2
Forest plot for pooled overall arrhythmias between AH and NG
FIGURE 3
FIGURE 3
Forest plot for pooled VA between AH and NG
FIGURE 4
FIGURE 4
Forest plot for pooled new‐onset AF between AH and NG
See this image and copyright information in PMC

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