Diabetes mellitus and adverse outcomes after carotid endarterectomy:A systematic review and meta-analysis

作     者：Fengshi Li Rui Zhang Xiao Di Shuai Niu Zhihua Rong Changwei Liu Leng Ni 

作者机构：Department of Vascular SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Breast Oncoplastic SurgeryHunan Cancer Hospital&The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangshaHunan 410031China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第12期

页      面：1401-1409页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：National Natural Science Foundation of China(No.81970417) National High Level Hospital Clinical Research Funding(No.2022-PUMCH-A-079) 

主　　题：Carotid artery stenosis Carotid endarterectomy Diabetes mellitus Meta-analysis 

摘      要：Background:There is still uncertainty regarding whether diabetes mellitus(DM)can adversely affect patients undergoing carotid endarterectomy(CEA)for carotid *** aim of the study was to assess the adverse impact of DM on patients with carotid stenosis treated by ***:Eligible studies published between 1 January 2000 and 30 March 2023 were selected from the PubMed,EMBASE,Web of Science,CENTRAL,and ClinicalTrials *** short-term and long-term outcomes of major adverse events(MAEs),death,stroke,the composite outcomes of death/stroke,and myocardial infarction(MI)were collected to calculate the pooled effect sizes(ESs),95%confidence intervals(CIs),and prevalence of adverse *** analysis by asymptomatic/symptomatic carotid stenosis and insulin/noninsulin-dependent DM was ***:A total of 19 studies(n=122,003)were *** the short-term outcomes,DM was associated with increased risks of MAEs(ES=1.52,95%CI:[1.15-2.01],prevalence=5.1%),death/stroke(ES=1.61,95%CI:[1.13-2.28],prevalence=2.3%),stroke(ES=1.55,95%CI:[1.16-1.55],prevalence=3.5%),death(ES=1.70,95%CI:[1.25-2.31],prevalence=1.2%),and MI(ES=1.52,95%CI:[1.15-2.01],prevalence=1.4%).DM was associated with increased risks of long-term MAEs(ES=1.24,95%CI:[1.04-1.49],prevalence=12.2%).In the subgroup analysis,DM was associated with an increased risk of short-term MAEs,death/stroke,stroke,and MI in asymptomatic patients undergoing CEA and with only short-term MAEs in the symptomatic *** insulin-and noninsulin-dependent DM patients had an increased risk of short-term and long-term MAEs,and insulin-dependent DM was also associated with the short-term risk of death/stroke,death,and ***:In patients with carotid stenosis treated by CEA,DM is associated with short-term and long-term *** may have a greater impact on adverse outcomes in asymptomatic patients after ***-dependent DM may have a more significant impact on post-CEA adverse outcom