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Prognostic value of admission glycated haemoglobin in unknown diabetic patients with acute myocardial infarction.
- Source :
-
European heart journal. Acute cardiovascular care [Eur Heart J Acute Cardiovasc Care] 2014 Dec; Vol. 3 (4), pp. 347-53. Date of Electronic Publication: 2014 Mar 27. - Publication Year :
- 2014
-
Abstract
- Background: Acute glycometabolic derangement in non-diabetic patients with acute myocardial infarction (AMI) has been reported with discrepant prognostic results. The aim of the present study was to assess the prognostic impact of glycated haemoglobin (HbA1c) levels, reflecting long-term glycometabolic disturbance, in a population of patients without known diabetes mellitus.<br />Methods: We examined 601 consecutive prospective patients diagnosed with AMI and unknown diabetes mellitus. We analysed metabolic function as a stratified variable using three groups of patients according to HbA1c: Group 1 (< 5.5%): 222 patients (37%); Group 2 (5.5 to 6.4%): 337 patients (56%); Group 3 (>6.4%): 42 patients (7%). Association between HbA1c groups and classic cardiovascular risk factor and in-hospital outcomes were assessed through univariate and multivariate analysis.<br />Results: In-hospital mortality was 5% (32/601 patients). Higher HbA1c was associated with poor glycometabolic control, older patients, obesity, hypertension, Killip's class>1, increased heart rate, initial bundle branch block, atrial fibrillation and higher mortality during follow-up. In a multivariate adjusted risk, in-hospital mortality was associated with age (odds ratio (OR)= 1.056; 1-1.1; p=0.006), Killip's class>1 (OR=2.4; 1-6.1; p=0.05) and HbA1c (OR=1.5; 1.15-1.9; p=0.002). Hypertension (OR=0.39; 0.18-0.87; p=0.022) and angiotensin-converting enzyme inhibitors (OR=0.28; 0.12-0.69; p=0.005) were protective factors.<br />Conclusions: HbA1c is an important risk marker in the absence of a history of diabetes mellitus in patients with AMI. The optimal management strategy in these patients may contribute to decreased in-hospital mortality.<br /> (© The European Society of Cardiology 2014.)
- Subjects :
- Analysis of Variance
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 mortality
Diabetic Cardiomyopathies complications
Diabetic Cardiomyopathies mortality
Female
Humans
Incidental Findings
Male
Middle Aged
Myocardial Infarction blood
Myocardial Infarction mortality
Prognosis
Prospective Studies
Diabetes Mellitus, Type 2 diagnosis
Diabetic Cardiomyopathies diagnosis
Glycated Hemoglobin metabolism
Myocardial Infarction complications
Subjects
Details
- Language :
- English
- ISSN :
- 2048-8734
- Volume :
- 3
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- European heart journal. Acute cardiovascular care
- Publication Type :
- Academic Journal
- Accession number :
- 24676027
- Full Text :
- https://doi.org/10.1177/2048872614530574