1. The Value of Admission HbA1c Level in Diabetic Patients With Acute Coronary Syndrome
- Author
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Yat-Yin Lam, Rui-Jie Li, Joseph Y.S. Chan, Bryan P. Yan, Qing Zhang, Cheuk-Man Yu, Chi Yuen Chan, Ming Dong, and Chin Pang Chan
- Subjects
Male ,China ,Acute coronary syndrome ,medicine.medical_specialty ,Time Factors ,Heart Diseases ,Myocardial Infarction ,Clinical Investigations ,Kaplan-Meier Estimate ,Patient Readmission ,Risk Assessment ,Disease-Free Survival ,Angina ,Patient Admission ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Angina, Unstable ,Hospital Mortality ,Prospective Studies ,Myocardial infarction ,Acute Coronary Syndrome ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,Glycated Hemoglobin ,Chi-Square Distribution ,business.industry ,Unstable angina ,Hazard ratio ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Mace - Abstract
Background: Elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A1c levels) in patients with ACS is still undefined. Hypothesis: Hemoglobin A1c level may predict short-term outcome in patients with ACS. Methods: We conducted a retrospective study with prospective follow-up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA1c level, checked within 8 weeks of the index admission (optimal control group, HbA1c ≤7%; suboptimal control group, HbA1c >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short-term clinical outcomes were also compared between the 2 study groups. Results: In our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non–ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction, respectively. In-hospital mortality was similar in both HbA1c groups (3.37% vs 2.88%, P = 0.803). Six-month MACE was also similar (26.40% vs 26.47%, P = 0.919). All-cause mortality, cardiovascular mortality, symptom-driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6-month MACE and individual endpoints were also similar in both groups. Conclusions: This study suggests that HbA1c levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS. © 2011 Wiley Periodicals, Inc. The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Published
- 2011