Impact of elevated HbA1c on long-term mortality in patients presenting with acute myocardial infarction in daily clinical practice
| Autor: | At Marcel Gosselink, Arnoud Wj van 't Hof, Vincent Roolvink, Mark W. Kennedy, Peter R van Dijk, Petra C. Koopmans, Elvin Kedhi, Kor Miedema, Henk J. G. Bilo, Renicus S Hermanides, Robbert J. Slingerland, Jan-Henk E. Dambrink, Jan Paul Ottervanger, Jorik R. Timmer |
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| Přispěvatelé: | Lifestyle Medicine (LM), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors HbA1c Treatment outcome Myocardial Infarction PRIMARY ANGIOPLASTY acute myocardial infarction 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine EVENTS 03 medical and health sciences 0302 clinical medicine Diabetes mellitus GLYCEMIC CONTROL medicine Humans REPERFUSION In patient (primary) percutaneous coronary intervention Myocardial infarction Prospective Studies Registries Aged Glycated Hemoglobin HEMOGLOBIN A1C business.industry General Medicine Middle Aged medicine.disease Prognosis NONDIABETIC PATIENTS Clinical Practice Survival Rate PROGNOSTIC VALUE Elevated HbA1c HBA(1C) Emergency medicine ADMISSION GLUCOSE Long term mortality Female ANGIOGRAPHIC ASSESSMENT Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies |
| Zdroj: | European Heart Journal: Acute Cardiovascular Care, 9(6), 616-625. SAGE Publications Inc. European Heart Journal: Acute Cardiovascular Care, 9(6), 616-625. SAGE Publications Ltd |
| ISSN: | 2048-8726 |
| Popis: | Background: Long-term clinical outcome is less well known in up to presentation persons unknown with diabetes mellitus who present with acute myocardial infarction and elevated glycosylated haemoglobin (HbA1c) levels on admission. We aimed to study the prognostic impact of deranged HbA1c at presentation on long-term mortality in patients not known with diabetes, presenting with acute myocardial infarction. Methods: A single-centre, large, prospective observational study in patients with and without known diabetes admitted to our hospital for ST-segment elevation myocardial infarction (STEMI) and non-STEMI. Newly diagnosed diabetes mellitus was defined as HbA1c of 48 mmol/l or greater and pre-diabetes mellitus was defined as HbA1c between 39 and 47 mmol/l. The primary endpoint was all-cause mortality at short (30 days) and long-term (median 52 months) follow-up. Results: Out of 7900 acute myocardial infarction patients studied, 1314 patients (17%) were known diabetes patients. Of the 6586 patients without known diabetes, 3977 (60%) had no diabetes, 2259 (34%) had pre-diabetes and 350 (5%) had newly diagnosed diabetes based on HbA1c on admission. Both short-term (3.9% vs. 7.4% vs. 6.0%, p Conclusions: In the largest study to date, newly diagnosed or pre-diabetes was present in 33% of acute myocardial infarction patients and was associated with poor long-term clinical outcome. Newly diagnosed diabetes (HbA1c ⩾48 mmol/mol) is an independent predictor of long-term mortality. More attention to early detection of diabetic status and initiation of blood glucose-lowering treatment is necessary. |
| Databáze: | OpenAIRE |
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