A Systematic Review and Meta-analysis of the Effect of Apomorphine in Patients with Parkinson’s Disease

Abstract

Introduction:

Regarding a potential relationship between diabetes and the prognostic significance of hyperglycaemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycaemia on different outcomes in AMI patients whether they are diabetic or not.

Methods:

Using the following search strategy: ‘Diabetes’ or ‘Diabetic’ AND ‘Acute myocardial infarction’ OR ‘AMI’ AND ‘hyperglycemia’ OR ‘glucose level’, we searched PubMed, Web of Science and Scopus for eligible articles that should undergo the screening process to determine its ability to be included in our study. Using Review Manager version 5.4 software, we conducted the meta-analysis of the included studies by pooling the mean difference (MD) in continuous variables, number and total of dichotomous variables to measure the odds ratio (OR) and generic inverse variance of OR or hazard ratio (HR) as they were reported in the included studies.

Results:

The difference between diabetes and non-diabetes patients regarding blood glucose level was found to be statistically significant with standardised MD of 1.39 (95% confidence interval [CI]: 1.12, 1.66, P < 0.00001). Hyperglycaemia in diabetic patients was statistically significantly associated with mortality with HR of 1.92 (95% CI: 1.45, 2.55, P < 0.00001) and OR of 1.76 (95% CI: 1.15, 2.7, P = 0.01). In non-diabetic patients admitted with AMI, hyperglycaemia was statistically significantly associated with mortality with HR of 1.56 (95% CI: 1.31, 1.86, P < 0.00001) and OR of 2.89 (95% CI: 2.47, 3.39, P < 0.00001). Moreover, hyperglycaemia in diabetic patients admitted with AMI was statistically significantly associated with occurrence of MACE with HR of 1.9 (95% CI: 1.19, 3.03, P = 0.007) and hyperglycaemia in non-diabetic AMI patients was statistically significantly associated with occurrence of MACE with HR of 1.6 (95% CI: 1.15, 2.23, P = 0.006).

Conclusion:

Hyperglycaemia in AMI patients is a predictor of worse outcomes including MACE and mortality whether these patients are diabetic or not. Some factors act as predictors for mortality in these patients including older age, higher glucose levels on admission and high Killip class.