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

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.