Prognostic value of hemoglobin A1c level and one-year mortality in patients with non ST elevation myocardial infarction

Abstract

HbA1c, the most commonly used indicator of chronic glucose metabolism, is closely associated with cardiovascular disease. However, the relationship between HbA1c and the mortality of non ST elevation myocardial infarction (NSTEMI) patients is still undefined. Here, we aim to assess the effect of HbA1c on in-hospital and one-year mortality in patients with NSTEMI. A total of 340 patients with NSTEMI, 240 patients with diabetes mellitus (DM) were enrolled stratified into two groups according to HbA1c level. The primary end points included major adverse cardiac events (MACE) and one-year mortality. The association between baseline hemoglobin A1c and MACE was examined. Subgroup analysis by diabetic control showed that elevated HbA1c is associated increased one-year mortality in NSTEMI patients with DM (10,68% vs. 1.29%); P = 0,011. We identified HbA1c (OR: 8.23, 95% CI 1.10-61.36; P = 0.008) as an independent predictor of MACE and mortality at one year. Results from our study indicate that the admission level of HbA1c reflecting diabetic control is a predictor of one-year mortality and MACE in patients with NSTEMI. These results identify HbA1c to be an independent predictor of one-year mortality in patients with NSTEMI with DM.