Influence of prediabetes on the prognosis of patients with myocardial infarction: a meta-analysis.

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.