Impact of Admission Glycosylated Hemoglobin A1c on Angiographic Characteristics and Short Term Clinical Outcomes of Nondiabetic Patients with Acute ST-Segment Elevation Myocardial Infarction.

Islam El-Sherbiny,Tamer Saber,Baher Nabil,Fathy Elsayed Abdelgawad

doi:10.1155/2015/274892

Abstract

We aimed to assess the predictive value of admission HbA1c level in nondiabetic patients presented by acute STEMI, on outcome of PCI and short term outcome of adverse cardiac events. Methods. 60 nondiabetic patients were admitted to Cardiology Department, Zagazig University Hospital, with acute STMI: 27 patients with HbA1c levels of 4.5% to 6.4% (group 1), 17 patients with HbA1c levels of 6.5% to 8.5% (group 2), and 16 patients with HbA1c levels higher than 8.5% (group 3). Either invasive intervention was done at admission by (pPCI) or coronary angiography was done within month (3–28 days) from taking thrombolytic. Participants were followed up for 6 months. Results. There was significant difference among different groups of HbA1c as regards the number of diseased vessels, severity of CAD lesions (p value < 0.01), and TIMI flow grades (p value < 0.05). There was significant difference among different groups as regards the adverse cardiac events on short term follow-up period (p value < 0.05). Conclusion. The present study showed that admission higher HbA1c level in patients presented by acute STEMI is associated with more severe CAD, lower rate of complete revascularization, and higher incidence of adverse cardiac events.

Highlights

Stress hyperglycemia in ST-segment elevation myocardial infarction (STEMI) patients was found to be associated with significantly increased rates of mortality and congestive heart failure and shock [1,2,3]
Glycosylated hemoglobin A1c (HbA1c) is a measure of the average blood glucose levels over 2 months [6] and is minimally affected by acute hyperglycemia often observed in myocardial infarction (MI)
There was no significant difference between the three groups regarding age, sex, hypertension, smoking, family history, and obesity (p value > 0.05)

Summary

Introduction

Stress hyperglycemia in ST-segment elevation myocardial infarction (STEMI) patients was found to be associated with significantly increased rates of mortality and congestive heart failure and shock [1,2,3]. Most of these studies, were in trials of fibrinolytic therapy; the evidence linking hyperglycemia with an adverse prognosis in patients treated with primary percutaneous coronary intervention (pPCI) is limited and derived mainly from observational registries [4]. Glycosylated hemoglobin A1c (HbA1c) is a measure of the average blood glucose levels over 2 months [6] and is minimally affected by acute hyperglycemia often observed in myocardial infarction (MI).

Objectives

Results

Discussion

Conclusion