Effect of Intensive Insulin Therapy on Prognosis in Patients With Acute Myocardial Infarction
10.3881/j.issn.1000-503X.15772
- VernacularTitle:强化胰岛素治疗对急性心肌梗死患者的预后影响
- Author:
Huiruo LIU
1
,
2
,
3
,
4
;
Zeyu YANG
;
Dazhou LU
;
Feng XU
;
Yuguo CHEN
;
Chuanbao LI
Author Information
1. 山东大学齐鲁医院急诊科, 济南 250012
2. 山东省急危重症临床医学研究中心, 济南 250012
3. 山东省急危重症医学重点实验室, 济南 250012
4. 山东大学齐鲁医院胸痛中心, 济南 250012
- Keywords:
acute myocardial infarction;
intensive insulin therapy;
meta-analysis
- From:
Acta Academiae Medicinae Sinicae
2024;46(2):176-183
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy and safety of intensive insulin therapy in the pa-tients with acute myocardial infarction and provide guidance for improving the prognosis.Methods The articles involving the randomized controlled trials(RCT)focusing on the effects of intensive versus conventional insulin therapy on the clinical outcomes of the patients with acute myocardial infarction were retrieved from Cochrane,Embase,PubMed,CNKI,Wanfang Data,VIP,and CBM with the time interval from inception to October 2022.The data of each RCT were extracted and used for meta-analysis in RevMan5.4.Results A total of 8 arti-cles were included in this study,involving 726 patients(372 in the intensive insulin group and 354 in the nor-mal insulin group).The meta-analysis results showed that the intensive insulin group had lower incidence of major cardiovascular adverse events(RR =0.53,95%CI =0.44-0.64,P<0.001),lower all-cause mortality(RR = 0.51,95%CI =0.33-0.78,P =0.002),lower high-sensitivity C-reactive protein level on day 7(WMD =-2.00,95%CI =-2.17--1.83,P<0.001),higher left ventricular ejection fraction on day 30(WMD = 3.94,95%CI =2.45-5.43,P<0.001),and higher incidence of hypoglycemia events(RR =2.96,95%CI =1.12-7.83,P =0.030)than the normal insulin group.There was no significant difference between the two groups in terms of no-reflow event after percutaneous coronary intervention(RR =0.39,95%CI =0.14-1.13,P =0.080).Conclusion Intensive insulin therapy might be associated with more clinical benefits in the patients with acute myocardial infarction,while the conclusion remains to be confirmed by more studies.
