Association of baseline hemoglobin A1c levels with bleeding in patients with non-ST-segment elevation acute coronary syndrome underwent percutaneous coronary intervention

Abstract

Abstract Background The association between baseline hemoglobin A1c (HbA1c) levels before the percutaneous coronary intervention and bleeding is unclear in patients with non-ST-segment elevation acute coronary syndrome. Purpose To investigate the association between baseline HbA1c levels before the percutaneous coronary intervention and bleeding in patients with non-ST-segment elevation acute coronary syndrome. Methods This observational cohort study enrolled 6,283 consecutive patients with non-ST-segment elevation acute coronary syndrome, from 1 January 2010 to 31 December 2014. Based on baseline HbA1c levels, the patients were divided into the HbA1c <7% group (n=4,740) and the HbA1c ≥7% group (n=1,543). The primary outcomes are major bleeding events (BARC grades 3–5) and all-cause death during follow-up. Results Of the patients who were enrolled, 4,705 (74.9%) were male and 2,143 (34.1%) had a history of diabetes mellitus, with a mean (SD) age of 64.13 (10.32) years. Median follow-up duration was 3.21 years. Compared with HbA1c <7% patients, the risk of major bleeding events and all-cause was both higher in HbA1c ≥7% patients (major bleeding: adjusted hazard ratio, 1.62; 95% confidence interval, 1.04–2.53; P=0.032; all-cause death: adjusted hazard ratio, 1.26; 95% confidence interval, 1.03–1.55; P=0.027). The result of the subgroups analyses was consistent with the primary analyses. Conclusions Higher baseline HbA1c levels before percutaneous coronary intervention was associated with an increase in bleeding risk in non-ST-elevation acute coronary syndrome patients. This study suggests that the HbA1c levels should be taken into account for the prolonged antithrombotic strategies of non-ST-elevation acute coronary syndrome patients. Figure 1. Kaplan-Meier Analysis for Outcomes Funding Acknowledgement Type of funding source: Other. Main funding source(s): Science and Technology Planning Project of Guangzhou City (201707010002)