Prognostic Value of The Leuko-Glycemic Index in Acute Myocardial Infarction; a Systematic Review and Meta-Analysis

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 haveraised 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.

Two independentresearchers summarized records available in the four main databases of Medline (Via PubMed), Embase, Scopus, andWeb 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.

Eleven articles were included (3701 patients, 72.1% male). Based on the analyses, AUC, sensitivity, and speci-ficity 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 mortalitywere 21% and 5%, respectively. AUC, sensitivity, and specificity for LGI in prediction of major cardiac complicationsafter 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.

Although the results demonstrated that the LGI could predict mortality and acute cardiac complication after MI, the lowpost-test probability of LGI in risk stratification of patients raises questions regarding its applicability. Nevertheless, asmost of the available studies have been conducted in the Latino/Hispanic population, further evidence is warranted togeneralize the validity of this tool to other racial populations