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How does HbA1c predict mortality and readmission in patients with heart failure? A protocol for systematic review and meta-analysis

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机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China [2]The Guangzhou University of Chinese Medicine, Guangzhou 510405, China [3]Department of Critical Care Medicine, Guang‑dong Provincial Hospital of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China
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关键词: HbA1c Heart failure Mortality Readmission Systematic review and meta-analysis Protocol

摘要:
Accumulating evidence suggests that HbA1c levels, a common clinical indicator of chronic glucose metabolism over the preceding 2-3 months, are independent risk factors for cardiovascular disease, including heart failure. However, conflicting evidence obscures clear cutoffs of HbA1c levels in various heart failure populations. The aim of this review is to assess the possible predictive value and optimal range of HbA1c on mortality and readmission in patients with heart failure.A systematic and comprehensive search will be performed using PubMed, Embase, CINAHL, Scopus, and the Cochrane Library databases before December 2022 to identify relevant studies. All-cause mortality is the prespecified primary endpoint. Cardiovascular death and heart failure readmission are secondary endpoints of interest. We will only include prospective and retrospective cohort studies and place no restrictions on the language, race, region, or publication period. The ROBINS-I tool will be used to assess the quality of each included research. If there were sufficient studies, we will conduct a meta-analysis with pooled relative risks and corresponding 95% confidence intervals to evaluate the possible predictive value of HbA1c for mortality and readmission. Otherwise, we will undertake a narrative synthesis. Heterogeneity and publication bias will be assessed. If heterogeneity was significant among included studies, a sensitivity analysis or subgroup analysis will be used to explore the source of heterogeneity, such as diverse types of heart failure or patients with diabetes and non-diabetes. Additionally, we will conduct meta-regression to examine the time-effect and treatment-effect modifiers on all-cause mortality compared between different quantile of HbA1c levels. Finally, a restricted cubic spline model may be used to explore the dose-response relationship between HbA1c and adverse outcomes.This planned analysis is anticipated to identify the predictive value of HbA1c for mortality and readmission in patients with heart failure. Improved understanding of different HbA1c levels and their specific effect on diverse types of heart failure or patients with diabetes and non-diabetes is expected to be figured out. Importantly, a dose-response relationship or optimal range of HbA1c will be determined to instruct clinicians and patients.PROSPERO registration details: CRD42021276067.© 2023. The Author(s).

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出版当年[2022]版
大类 | 4 区 医学
小类 | 3 区 医学:内科
最新[2025]版
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2021]版:
Q2 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China [2]The Guangzhou University of Chinese Medicine, Guangzhou 510405, China [3]Department of Critical Care Medicine, Guang‑dong Provincial Hospital of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China
通讯作者:
通讯机构: [1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China [3]Department of Critical Care Medicine, Guang‑dong Provincial Hospital of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China
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