The role of the plasma glycosylated hemoglobin A1c/Apolipoprotein A-l ratio in predicting cardiovascular outcomes in acute coronary syndrome

Autor: Xuyu He, Kunyi Zhang, Feier Song, Yuan-Feng Liang, Liwen Li, Yu Zhou
Rok vydání: 2021
Předmět:
Male
Acute coronary syndrome
medicine.medical_specialty
Time Factors
Endocrinology
Diabetes and Metabolism
Medicine (miscellaneous)
030209 endocrinology & metabolism
030204 cardiovascular system & hematology
Coronary Angiography
Logistic regression
Risk Assessment
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Insulin resistance
Predictive Value of Tests
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Humans
Longitudinal Studies
Acute Coronary Syndrome
Aged
Retrospective Studies
Glycated Hemoglobin
Nutrition and Dietetics
Apolipoprotein A-I
medicine.diagnostic_test
business.industry
Proportional hazards model
nutritional and metabolic diseases
Odds ratio
Middle Aged
Prognosis
medicine.disease
Cardiology
Female
lipids (amino acids
peptides
and proteins)
Insulin Resistance
Cardiology and Cardiovascular Medicine
Lipid profile
business
Biomarkers
Zdroj: Nutrition, Metabolism and Cardiovascular Diseases. 31:570-578
ISSN: 0939-4753
Popis: Background and aims Glucose and lipid metabolism are major prognostic indicators of coronary heart disease. The ratio of plasma glycosylated hemoglobin A1c (HbA1c) to apolipoprotein A-l (ApoA-l) is an indirect measure of insulin resistance. The study aimed to evaluate whether the HbA1c/ApoA-1 ratio can predict the prognosis in patients with the acute coronary syndrome (ACS). Methods and results A total of 476 ACS patients diagnosed by coronary angiography were enrolled in this longitudinal, observational, retrospective study. Plasma HbA1c, fasting blood glucose and lipid profile were measured. Patients were stratified according to the tertiles of HbA1c/ApoA-l levels. Cox proportional hazard model was used to examine the predictive value of HbA1c/ApoA-l for study endpoints. The association between the Log HbA1c/ApoA-l ratio and major adverse cardiovascular events (MACEs) was estimated using multiple logistic regression. Baseline characteristics showed a mean age of 66 ± 8 years, and 52.5% were hypertensive, 26.8% diabetic, and 54.5% current or prior smokers. During a mean follow-up period of 22.3 ± 1.7 months, 59 deaths occurred. After adjusting for age, gender, smoking, hypertension, diabetes, and coronary artery disease severity, patients in the highest HbA1c/ApoA-l ratio tertile had a 4.36-fold increased risk of mortality compared with those in the lowest tertile. The multivariate logistic regression showed that the Log HbA1c/ApoA-l ratio was associated with MACEs (Odds ratio 2.95, p = 0.013). Conclusion After adjusting for traditional cardiovascular risk factors and ACS severity scores, the HbA1c/ApoA-1 ratio remained an independent predictor of all-cause mortality and MACEs in the ACS patients undergoing angiography.
Databáze: OpenAIRE
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