DataSheet_1_Sex-specific impact of diabetes on all-cause mortality among adults with acute myocardial infarction: An updated systematic review and meta-analysis, 1988-2021.docx

BackgroundThe prevalence of diabetes and its impact on mortality after acute myocardial infarction (AMI) are well-established. Sex-specific analyses of the impact of diabetes on all-cause mortality after AMI have not been updated and comprehensively investigated.ObjectiveTo conduct a systematic review and meta-analysis that examined sex-specific short-term, mid-term and long-term all-cause mortality associated with diabetes among AMI survivors (diabetes versus non-diabetes patients in men and women separately), using up-to-date data.MethodsWe systematically searched Embase and MEDLINE for studies that were published from inception to November 14, 2021. Studies were included if (1) they studied post-AMI all-cause-mortality in patients with and without diabetes, (2) sex-specific all-cause mortality at short-term (in-hospital or within 90 days after discharge), mid-term (>90 days and within 5 years), and/or long-term (>5 years) were reported. From eligible studies, we used random effects meta-analyses models to estimate pooled unadjusted and adjusted sex-specific risk ratio (RR) of all-cause mortality at short-, mid-, and long-term follow-up for adults with diabetes compared with those without diabetes.ResultsOf the 3647 unique studies identified, 20 studies met inclusion criteria. In the unadjusted analysis (Total N=673,985; women=34.2%; diabetes patients=19.6%), patients with diabetes were at a higher risk for all-cause mortality at short-term (men: RR, 2.06; women: RR, 1.83); and mid-term follow-up (men: RR, 1.69; women: RR, 1.52) compared with those without diabetes in both men and women. However, when adjusted RRs were used (Total N=7,144,921; women=40.0%; diabetes patients=28.4%), the associations between diabetes and all-cause mortality in both men and women were attenuated, but still significantly elevated for short-term (men: RR, 1.16; 95% CI, 1.12-1.20; women: RR, 1.29; 95% CI, 1.15-1.46), mid-term (men: RR, 1.39; 95% CI, 1.31-1.46; women: RR, 1.38; 95% CI, 1.20-1.58), and long-term mortality (men: RR, 1.58; 95% CI, 1.22-2.05; women: RR, 1.76; 95% CI, 1.25-2.47). In men, all-cause mortality risk associated with diabetes tended to increase with the duration of follow-up (p

背景：糖尿病的流行及其对急性心肌梗死（AMI）后死亡率的影響已經得到確立。對於AMI後全因死亡率中糖尿病對性別特異性影響的分析尚未得到更新和全面的調查。目標：進行系統综述和荟萃分析，檢視糖尿病患者在AMI後短期（入院或出院後90天內）、中期（>90天且在5年內）和長期（>5年）的全因死亡率與非糖尿病患者的性別特異性關係（男性與女性分別對比），並使用最新數據。方法：我們系統性地搜索了從創刊至2021年11月14日的Embase和MEDLINE，包括以下條件的研討：1）研究患有和未患有糖尿病的患者在AMI後的全因死亡率；2）報告了短期（入院或出院後90天內）、中期（>90天且在5年內）和/或長期（>5年）的性別特異性全因死亡率。從合格研究中，我們使用隨機效應荟萃分析模型來估計糖尿病成年患者與無糖尿病患者在短期、中期和長期追蹤中的全因死亡率合并未調整和調整後的性別特異性風險比（RR）。結果：在識別的3647個獨特研究中，有20個研究符合選擇標準。在未調整的分析中（總N=673,985；女性=34.2%；糖尿病患侶=19.6%），與無糖尿病的患者相比，糖尿病患者在短期（男性：RR，2.06；女性：RR，1.83）和中期追蹤（男性：RR，1.69；女性：RR，1.52）的全因死亡率風險更高；然而，當使用調整後的RR時（總N=7,144,921；女性=40.0%；糖尿病患侶=28.4%），糖尿病與男性與女性全因死亡率之間的關係被緩解，但對短期（男性：RR，1.16；95% CI，1.12-1.20；女性：RR，1.29；95% CI，1.15-1.46）、中期（男性：RR，1.39；95% CI，1.31-1.46；女性：RR，1.38；95% CI，1.20-1.58）和長期死亡率（男性：RR，1.58；95% CI，1.22-2.05；女性：RR，1.76；95% CI，1.25-2.47）的相關性仍然顯著升高。在男性中，與糖尿病相關的全因死亡率風險隨著追蹤期間的延長而增加（p