In-hospital fasting hyperglycemia and increased risk of mortality after acute coronary syndrome: a systematic overview and meta-analysis

Background Several studies noted that increased fasting blood glucose in hospital is associated with increasing mortality of acute coronary syndrome (ACS). We conducted a meta-analysis to assess the risk of mortality after ACS in patients who had fasting hyperglycemia (FH) in hospital. Methods We conducted searches on PubMed, Cochrane Library, Web of Science, and Embase for relevant studies published before August 31, 2019. We pooled odds ratios (OR) from individual studies using a random effects model. Data abstraction was conducted by two independent reviewers, and the meta-analysis was performed using Review Manager version 5.3. Results Eight studies were included into our research. Patients with FH showed a 3.09-fold (OR 3.09, CI 2.64-3.61; p < 0.00001) increased mortality of patients during admission compared with those who had normal fasting blood glucose (FBG). A statistically significant difference in post hospitalization mortality between patients with and without in-hospital FH was also detected (OR 3.40, CI 2.80-4.14; p < 0.00001). Conclusions The available evidence suggests that in-hospital FH could increase the risk of in-hospital and out-of-hospital (30-day and long-term) mortalities after ACS.