The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome.

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 A(1c) levels) in patients with ACS is still undefined. HYPOTHESIS:Hemoglobin A(1c) 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 HbA(1c) level, checked within 8 weeks of the index admission (optimal control group, HbA(1c) ≤7%; suboptimal control group, HbA(1c) >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 HbA(1c) 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 HbA(1c) levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Chan CY,Li R,Chan JY,Zhang Q,Chan CP,Dong M,Yan BP,Lam YY,Yu CM

doi

10.1002/clc.20915

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

507-12

issue

8

eissn

0160-9289

issn

1932-8737

journal_volume

34

pub_type

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