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It is well known that hyperglycemia and elevated HbA1c level on admission are poor prognostic factors in diabetic patients with acute myocardial infarction (AMI). but the use of intensive therapy to target normal HbA1c level increased mortality and did not significantly reduce major cardiovascular events in ACCORD Study. is the less than 6.0% HbA1c level on admission safe in diabetic patients with AMI? The aim of this study was to determine the contribution of HbA1c at admission on prognosis of AMI.
A total of 2,679 diabetic patients with AMI in KorMI registry between January 2008 and August 2011. There are 1,360 ST segment elevation myocardial infarction and 1319 non ST segment elevation myocardial infarction. Plasma HbA1c levels were available for all patients. We categorized the patients according to HbA1c level, Group I <6%, Group II ≥6. 1-month and 12-month major adverse cardiac event (MACE) was defined as either all cause of death, myocardial infarction and any type of revascularization.
Less than 6.0% HbA1c Group I had a higher 1-month and 12-month MACE than over the 6.0% HbA1c Group II. In multiple logistic regression analysis, less than 6.0% HbA1c was related to an increased risk of developing MACE (odds ratio 2.80, 95% confidence interval 1.63-4.80, p=0.001).
Less than 6.0% HbA1c on admission might be an important poor prognostic factor in diabetic patients with AMI at 1-month and 12-month follow-up.
|1 month MACE||29 (14.4%)||205 (8.3%)||p<0.01|
|12 month MACE||43 (21.4%)||322 (13.0%)||p<0.001|
- 2013 American College of Cardiology Foundation