Prognostic Value of The Leuko-Glycemic Index in Acute Myocardial Infarction; a Systematic Review and Meta-Analysis
Archives of Academic Emergency Medicine,
Vol. 11 No. 1 (2023),
15 November 2022
,
Page e25
https://doi.org/10.22037/aaem.v11i1.1915
Abstract
Introduction: In recent years, studies have provided evidence on the prognostic value of the leuko-glycemic index (LGI) in acute myocardial infarction (MI), but there is a lack of consensus. In addition, various reported cut-offs for LGI have raised concern regarding its clinical applicability. So, to conclude, through this systematic review and meta-analysis, we aimed to investigate all available evidence on the prognostic value of LGI in acute MI.
Methods: Two independent researchers summarized records available in the four main databases of Medline (Via PubMed), Embase, Scopus, and Web of Science until 15 Sep 2022. Articles studying the prognostic value of the LGI in acute MI were included. Finally, sensitivity, specificity, prognostic odds ratio, and the area under the curve (AUC) for LGI were analyzed and reported.
Results: Eleven articles were included (3701 patients, 72.1% male). Based on the analyses, AUC, sensitivity, and specificity for LGI in prediction of mortality following acute MI were 0.77 (95% CI: 0.73 to 0.80), 0.75 (95% CI: 0.62 to 0.84), and 0.66 (95% CI: 0.51 to 0.78), respectively. Positive and negative post-test probability of LGI in prediction of mortality were 21% and 5%, respectively. AUC, sensitivity, and specificity for LGI in prediction of major cardiac complications after acute MI were 0.81 (95% CI: 0.77 to 0.84), 0.84 (95% CI: 0.70 to 0.92), and 0.64 (95% CI: 0.49 to 0.84), respectively. Also, the Positive and negative post-test probability of LGI in this regard were 59% and 13%, respectively.
Conclusion: Although the results demonstrated that the LGI could predict mortality and acute cardiac complication after MI, the low post-test probability of LGI in risk stratification of patients raises questions regarding its applicability. Nevertheless, as most of the available studies have been conducted in the Latino/Hispanic population, further evidence is warranted to generalize the validity of this tool to other racial populations.
- Glycemic index
- prognosis
- acute coronary syndrome
- myocardial ischemia
- death
- myocardial infarction
How to Cite
References
Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021.
Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi S, AlKatheeri R, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus. 2020;12(7):e9349.
Vliegenthart R, Morris PB. Computed tomography coronary artery calcium scoring: review of evidence base and cost-effectiveness in cardiovascular risk prediction. J Thorac Imaging. 2012;27(5):296-303.
Kreisz FP, Merlin T, Moss J, Atherton J, Hiller JE, Gericke CA. The pre-test risk stratified cost-effectiveness of 64-slice computed tomography coronary angiography in the detection of significant obstructive coronary artery disease in patients otherwise referred to invasive coronary angiography. Heart Lung Circ. 2009;18(3):200-7.
Haji Aghajani M, Madani Neishaboori A, Ahmadzadeh K, Toloui A, Yousefifard M. The association between apolipoprotein A-1 plasma level and premature coronary artery disease: A systematic review and meta-analysis. Int J Clin Pract. 2021;75(11):e14578.
Haji Aghajani M, Toloui A, Ahmadzadeh K, Madani Neishaboori A, Yousefifard M. Premature Coronary Artery Disease and Plasma Levels of Interleukins; a Systematic Scoping Review and Meta-Analysis. Arch Acad Emerg Med. 2022;10(1):e51.
Ramezani F, Ahmadi S, Faridaalee G, Baratloo A, Yousefifard M. Value of Manchester Acute Coronary Syndromes Decision Rule in the Detection of Acute Coronary Syndrome; a Systematic Review and Meta-Analysis. Emerg (Tehran). 2018;6(1):e61.
Baratloo A, Mohamadi M, Mohammadi M, Toloui A, Madani Neishaboori A, Rafiei Alavi SN, et al. The value of predictive instruments in the screening of acute stroke: an umbrella review on previous systematic reviews. Front Emerg Med. 2022;6(3):e38.
Hosseini M, Ahmadzadeh H, Toloui A, Ahmadzadeh K, SN RA, Gubari M, et al. The value of interleukin levels in the diagnosis of febrile urinary tract infections in children and adolescents; a systematic review and meta-analysis. J Pediatr Urol. 2022 ;18(2):211-223.
Yousefifard M, Ahmadzadeh K, Toloui A, Ahmadzadeh H, Neishaboori AM, Alavi SNR, et al. Assessing the value of serum and urinary interleukins for diagnosis of acute kidney injury in children and adolescents: A systematic review and meta-analysis. Pract Lab Med. 2022;28:e00262.
Medina-Leyte DJ, Zepeda-García O, Domínguez-Pérez M, González-Garrido A, Villarreal-Molina T, Jacobo-Albavera L. Endothelial Dysfunction, Inflammation and Coronary Artery Disease: Potential Biomarkers and Promising Therapeutical Approaches. Int J Mol Sci. 2021;22(8):3850.
Carranza Zambrano LM. Indice leucoglucémico como marcador de valor pronóstico en pacientes con síndrome coronario agudo. El estudio se ha realizado en el Hospital Eugenio Espejo entre enero y diciembre del 2016: Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina; 2018;[Thesis].
Kamińska J, Koper OM, Siedlecka-Czykier E, Matowicka-Karna J, Bychowski J, Kemona H. The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes. Saudi J Biol Sci. 2018;25(7):1263-71.
Quiroga W, Conci E, Zelaya F, Isa M, Pacheco G, Sala J. Estratificación del riesgo en el infarto agudo de miocardio según el índice leucoglucémico.¿ El Killip-Kimball de laboratorio. Rev Fed Arg Cardiol. 2010;39(1):29-34.
Qi L-Y, Liu H-X, Cheng L-C, Luo Y, Yang S-Q, Chen X, et al. Prognostic value of the leuko-glycemic index in acute myocardial infarction patients with or without diabetes. Diabetes, Diabetes Metab Syndr Obes. 2022;15:1725-36.
Padilla-Cueto D, Hernández-Negrín H, Ramírez-Gómez JI, Pérez-Valdivia A, Cárdenas-Sánchez AL, Alfonso-Izquierdo A. The leucoglycaemic index is a predictor of one-year all-cause mortality in Cuban patients with ST-segment elevation acute myocardial infarction. CorSalud. 2019;11(1):21-9.
Padilla-Cueto DI, Hernández-Negrín H, Pérez-Valdivia A, Barreto-Fiu E, Ramírez-Gómez JI. Prognostic factors of hospital mortality in patients with ST elevation myocardial infarction. Hospital Arnaldo Milián Castro. Villa Clara, Cuba. 2015. Med UIS. 2017;30(3):67-72.
Seoane LA, Burgos L, Espinoza JC, et al. Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting. Braz J Cardiovasc Surg. 2021;36(4):484-491.
Cuesta-Mero PL, García-Romo LA, Villacres-López ÁD. Leukoglucemic index as a prognostic marker for complications in patients with acute myocardial infarction. Rev Colomb Cardiol. 2021;28(2):119-27.
Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529-36.
Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380-2.
Díaz Beníteza RE, Morales AMC, Hernández LMR, Sánchez PAC, Herrera YC, Rivera EMG. Glycosylated hemoglobin and leukoglycemic index as prognostic determinations in acute coronary syndrome. CorSalud (Revista de Enfermedades Cardiovasculares). 2016;8(3):153-63.
Hirschson Prado A, Higa C, Merlo P, Domine E, Blanco P, Vazquez G, et al. Prognostic value of the leuko-glycemic index in acute myocardial infarction. Results from the SCAR multicenter registry. Rev Argent Cardiol. 2014;82:475-480.
León-Aliz E, Moreno-Martínez FL, Pérez-Fernández GA, Vega-Fleites LF, Rabassa-López-Calleja MA. Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial infarction. Clin Invest Arterioscl. 2014;26(4):168-75.
Martínez García G, Cisneros Sánchez LG, Chipi Rodríguez Y, González Miguelez Y, Sánchez Valcázar SM, Silva Brito D, et al. Leukoglycemic index as predictor of in-hospital complications in acute myocardial infarction. Rev Fed Argent Cardiol. 2021;50(4):135-9.
Martínez Saldaña A, Rodríguez MM, González AL. Leuko-glycemic index and complications in patients with acute coronary syndrome. Med Crít. 2018;32(1):27-33.
Quiroga Castro W, Conci E, Zelaya F, Isa M, Pacheco G, Sala J, et al. Stratification of Risk in Acute Myocardial Infarction According to Index Leuko-Glycemic. Circulation. 2010;122(2):E160-E1.
Rodríguez Jiménez A, Rodríguez RF, Rodríguez ET, Cañizarez GQ. Leuko-glycemic index as a prognostic factor after acute myocardial infarction with ST-segment elevation. Rev Finl. 2019;9(2):97-107.
Deckers JW, van Domburg RT, Akkerhuis M, Nauta ST. Relation of admission glucose levels, short-and long-term (20-year) mortality after acute myocardial infarction. Am J Cardiol. 2013;112(9):1306-10.
Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T, et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2008;117(12):1610-9.
Terlecki M, Bednarek A, Kawecka-Jaszcz K, Czarnecka D, Bryniarski L. Acute hyperglycaemia and inflammation in patients with ST segment elevation myocardial infarction. Kardiol Pol. 2013;71(3):260-7.
Singh K, Hibbert B, Singh B, Carson K, Premaratne M, Le May M, et al. Meta-analysis of admission hyperglycaemia in acute myocardial infarction patients treated with primary angioplasty: a cause or a marker of mortality? Eur Heart J Cardiovasc Pharmacother. 2015;1(4):220-8.
Trongtorsak A, Kewcharoen J, Thangjui S, Yanez‐Bello MA, Sous M, Prasai P, et al. Admission hyperglycemia in acute myocardial infarction is associated with an increased risk of arrhythmias: A systematic review and meta‐analysis. J Arrhythm. 2022;38(3):307-315.
Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106(16):2067-72.
Granger CB, Kochar A. Understanding and targeting inflammation in acute myocardial infarction: an elusive goal. J Am Coll Cardiol. 2018. p. 199-201.
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