Abstract
BackgroundAcute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. The underlying mechanism remains elusive and there is a shortage of serum prediction markers. In this study, we investigate the relationship between admission HbA1c and severity of coronary artery stenosis and subsequent prognosis in AMI patients with or without diabetes.Research design and methodsWe measured admission HbA1c, and vessel scores based on the number of diseased coronary vessels with significant stenosis in 628 patients diagnosed with AMI. Simple and multi-regression analysis were performed to investigate the correlation between HbA1c and the severity of coronary artery stenosis. Major adverse cardiovascular events (MACE), including new-onset myocardial infarction, acute heart failure and cardiac death, were documented during the follow-up. 272 non-DM participants and 137 DM participants were separated into two groups based on HbA1c levels for survival analysis during a 2-year follow up.Results448 non-DM patients and 180 DM patients were included in the initial observational analysis. 272 non-DM patients and 137 DM patients were included in the follow-up survival analysis. The admission HbA1c level was found to be significantly positively correlated to the number of affected vessels suffering from significant coronary artery stenosis both in DM (R square = 0.012; 95% CI 0.002 to 0.623, P = 0.049) and non DM patients (R square = 0.025; 95% CI 0.009 to 0.289, P = 0.037). Kaplan–Meier survival analysis revealed no significant difference with regard to different HbA1c levels either in DM or non-DM patients at the end of follow-up.ConclusionsIn patients with AMI, admission HbA1c is an important predictor for the severity of coronary artery stenosis in non-DM and DM patients. Further studies are needed to determine whether longer term follow-up could further identify the prognosis effect of HbA1c on MACE.
Highlights
Acute myocardial infarction (AMI) is one of the leading health threatening diseases in the world [1, 2] and it remains the most common cause for morbidity and mortality in patients with type 2 diabetes disease (T2DM) [3]
The admission H bA1c level was found to be significantly positively correlated to the number of affected vessels suffering from significant coronary artery stenosis both in diabetes mellitus (DM) (R square = 0.012; 95% CI 0.002 to 0.623, P = 0.049) and non DM patients (R square = 0.025; 95% CI 0.009 to 0.289, P = 0.037)
In patients with AMI, admission hemoglobin A 1c (HbA1c) is an important predictor for the severity of coronary artery stenosis in non-DM and DM patients
Summary
Acute myocardial infarction (AMI) is one of the leading health threatening diseases in the world [1, 2] and it remains the most common cause for morbidity and mortality in patients with type 2 diabetes disease (T2DM) [3]. AMI patients with T2DM are known to present with multiple vessel lesion during coronary angiography, the underlying mechanism remains elusive and there is a shortage of serum prediction markers [4, 5]. Acute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. We investigate the relationship between admission H bA1c and severity of coronary artery stenosis and subsequent prognosis in AMI patients with or without diabetes. Major adverse cardiovascular events (MACE), including new-onset myocardial infarction, acute heart failure and cardiac death, were documented during the follow-up. 272 non-DM participants and 137 DM participants were separated into two groups based on HbA1c levels for survival analysis during a 2-year follow up
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