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The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome.
Clin Cardiol 2011; 34(8):507-12CC

Abstract

BACKGROUND

Elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A(1c) levels) in patients with ACS is still undefined.

HYPOTHESIS

Hemoglobin A(1c) level may predict short-term outcome in patients with ACS.

METHODS

We conducted a retrospective study with prospective follow-up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA(1c) level, checked within 8 weeks of the index admission (optimal control group, HbA(1c) ≤7%; suboptimal control group, HbA(1c) >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short-term clinical outcomes were also compared between the 2 study groups.

RESULTS

In our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction, respectively. In-hospital mortality was similar in both HbA(1c) groups (3.37% vs 2.88%, P = 0.803). Six-month MACE was also similar (26.40% vs 26.47%, P = 0.919). All-cause mortality, cardiovascular mortality, symptom-driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6-month MACE and individual endpoints were also similar in both groups.

CONCLUSIONS

This study suggests that HbA(1c) levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21717470

Citation

Chan, Chi Yuen, et al. "The Value of Admission HbA(1c) Level in Diabetic Patients With Acute Coronary Syndrome." Clinical Cardiology, vol. 34, no. 8, 2011, pp. 507-12.
Chan CY, Li R, Chan JY, et al. The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome. Clin Cardiol. 2011;34(8):507-12.
Chan, C. Y., Li, R., Chan, J. Y., Zhang, Q., Chan, C. P., Dong, M., ... Yu, C. M. (2011). The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome. Clinical Cardiology, 34(8), pp. 507-12. doi:10.1002/clc.20915.
Chan CY, et al. The Value of Admission HbA(1c) Level in Diabetic Patients With Acute Coronary Syndrome. Clin Cardiol. 2011;34(8):507-12. PubMed PMID: 21717470.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome. AU - Chan,Chi Yuen, AU - Li,Ruijie, AU - Chan,Joseph Yat Sun, AU - Zhang,Qing, AU - Chan,Chin Pang, AU - Dong,Ming, AU - Yan,Bryan P, AU - Lam,Yat-Yin, AU - Yu,Cheuk-Man, Y1 - 2011/06/29/ PY - 2010/11/25/received PY - 2011/02/26/accepted PY - 2011/7/1/entrez PY - 2011/7/1/pubmed PY - 2011/12/13/medline SP - 507 EP - 12 JF - Clinical cardiology JO - Clin Cardiol VL - 34 IS - 8 N2 - BACKGROUND: Elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A(1c) levels) in patients with ACS is still undefined. HYPOTHESIS: Hemoglobin A(1c) level may predict short-term outcome in patients with ACS. METHODS: We conducted a retrospective study with prospective follow-up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA(1c) level, checked within 8 weeks of the index admission (optimal control group, HbA(1c) ≤7%; suboptimal control group, HbA(1c) >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short-term clinical outcomes were also compared between the 2 study groups. RESULTS: In our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction, respectively. In-hospital mortality was similar in both HbA(1c) groups (3.37% vs 2.88%, P = 0.803). Six-month MACE was also similar (26.40% vs 26.47%, P = 0.919). All-cause mortality, cardiovascular mortality, symptom-driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6-month MACE and individual endpoints were also similar in both groups. CONCLUSIONS: This study suggests that HbA(1c) levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS. SN - 1932-8737 UR - https://www.unboundmedicine.com/medline/citation/21717470/The_value_of_admission_HbA_1c__level_in_diabetic_patients_with_acute_coronary_syndrome_ L2 - https://doi.org/10.1002/clc.20915 DB - PRIME DP - Unbound Medicine ER -