Prognostic significance of HbA1c in patients with AMI treated invasively and newly detected glucose abnormalities
| Autor: | Grzegorz Mencel, Andrzej Swiatkowski, Agnieszka Sedkowska, Teresa Zielińska, Zbigniew Kalarus, Michał Mazurek, Jacek Kowalczyk, Radosław Lenarczyk, Beata Sredniawa, Paweł Francuz |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology medicine.medical_treatment Myocardial Infarction Comorbidity Kaplan-Meier Estimate Impaired glucose tolerance Percutaneous Coronary Intervention Predictive Value of Tests Risk Factors Diabetes mellitus Internal medicine Glucose Intolerance medicine Diabetes Mellitus Humans In patient Myocardial infarction Prospective Studies Registries Coronary Artery Bypass Propensity Score Aged Proportional Hazards Models Glycated Hemoglobin business.industry Percutaneous coronary intervention Glucose Tolerance Test Middle Aged medicine.disease Up-Regulation Logistic Models Treatment Outcome Multivariate Analysis Cardiology Female Poland Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | European journal of preventive cardiology. 22(6) |
| ISSN: | 2047-4881 |
| Popis: | Glucose abnormalities are frequent comorbidities influencing prognosis in patients with cardiovascular diseases. The objective of this study was to evaluate prognostic role of HbA1c in patients with acute myocardial infarction (AMI) treated invasively, who had newly detected glucose abnormalities.Single-centre registry encompassed 2146 survivors of AMI. In all patients without diabetes mellitus (DM), oral glucose tolerance test was performed before hospital discharge and interpreted according to the guidelines.From the study population, two major groups with defined new glucose abnormalities and estimated HbA1c were selected: 457 patients with impaired glucose tolerance (IGT) and 306 patients with newly detected DM (newDM). In each of these groups, the median value of HbA1c was calculated and established as the cut-off point for further analysis. The median HbA1c for IGT group was 5.9% and for newDM was 7.0%.Patients with IGT and HbA1c ≤ 5.9% had significantly lower posthospital mortality (4.5%) than those with HbA1c5.9% (25.0%; p0.001). Similarly, patients with newDM and HbA1c ≤7.0% had lower mortality (6.4%) than those with HbA1c7.0% (14.3%; p0.05). Multivariate regression analysis revealed that increase of HbA1c was one of the strongest independent risk factors of death among IGT patients (HR 2.9, 95% CI 2.7-3.1; p0.001) and newDM (HR 1.53, 95% CI 1.39-1.66; p0.05).Increase of HbA1c in patients with newly detected glucose abnormalities was associated with significantly reduced survival after AMI treated invasively. Moreover, increase of HbA1c in patients with IGT and newDM was one of the strongest independent risk factors of death in these populations. |
| Databáze: | OpenAIRE |
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