Hemoglobin A1c as a prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction

Çiçek, Gökhan; Uyarel, Hüseyin; Ergelen, Mehmet; Ayhan, Erkan; Abanonu, Gul Babacan; Eren, Mehmet; Gibson, C. Michael

doi:10.1097/mca.0b013e328342c760

Cited by 41 publications

(36 citation statements)

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“…Results from previous studies were controversial [3,8,[10][11][12][13][14]. Considering the different management and treatment strategies [15], the effects that high HbA 1c level have on STEMI patients might differ from other types of CAD.…”

Section: Introductionmentioning

confidence: 99%

“…After scanning the titles, abstracts, reading full texts and hand searching the reference lists of candidate articles, we finally got 19 prospective studies including a total of 35,994 STEMI patients to evaluate the associations between HbA 1c level and their in-hospital, 30-day and long-term mortality. Among these studies, there were 13 studies from Asia [3,8,10,12,13,[23][24][25][26][27][28][29][30], 5 from Europe [11,[31][32][33][34] and 1 from North America [35]. Detailed information of the eligible studies was shown in Table 1.…”

Section: Eligible Studiesmentioning

confidence: 99%

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Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Hou

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Many studies have shown the prognostic significance of glycated hemoglobin (HbA 1c ) for overall coronary artery disease (CAD). But less is known about the role that HbA 1c played in the prognosis of patients diagnosed with ST-segment elevation myocardial infarction (STEMI).Results from previous studies were controversial. Therefore, a meta-analysis was conducted to investigate whether admission HbA 1c level was a predictor of short-and longterm mortality rates among patients diagnosed with STEMI. Relevant literatures were retrieved from the electronic databases up to March 2016. Reference lists were hand searched to identify eligible studies. Articles were included if they provided sufficient information for the calculation of pooled relative risk (RR) and its corresponding 95% confidence interval (CI). Finally, we got 19 prospective studies involving a total of 35,994 STEMI patients to evaluate the associations between HbA 1c level and their in-hospital, 30-day and long-term mortality. Among STEMI patients, HbA 1c level was not significantly associated with in-hospital mortality (RR 1.20, 95% CI 0.95-1.53, p = 0.13). However, elevated HbA 1c level was positively associated with risk of 30-day and long-term mortality (for 30-day mortality, RR 1.25, 95% CI 1.03-1.52, p = 0.02; for long-term mortality, RR 1.45, 95% CI 1.20-1.76, p < 0.01). In conclusion, our findings suggested elevated HbA 1c level among STEMI patients was an indicator of 1.25-fold 30-day mortality risk and 1.45-fold long-term mortality risk, respectively. STEMI patients with high HbA 1c level should have their chronic glucose dysregulation under intensive control.

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Section: Introductionmentioning

confidence: 99%

Section: Eligible Studiesmentioning

confidence: 99%

Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Hou

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…As discussed before, previous trials designed to answer this question were diverse and reached different conclusions [8,9,10,11]. …”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, this approach was implemented in previous studies [2,9,11]. Second, the study population was derived from a single-center registry and as such is prone to a lesser degree of diversity.…”

Section: Discussionmentioning

confidence: 99%

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HbA<sub>1c</sub> Levels and Long-Term Mortality in Patients Undergoing Coronary Angiography

et al. 2016

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Objectives: Previous studies investigating the prognostic value of HbA_1c in patients undergoing coronary angiography reported a mixed pattern of results. Therefore, we aimed to better define the prognostic power of HbA_1c among coronary catheterized patients. Methods: Patients undergoing coronary angiography (n = 3,749) were divided into four groups according to HbA_1c levels (<5, 5-6, 6-7 and >7%). Cox regression models assessed long-term mortality after adjusting for multiple covariates. Results: Baseline clinical profiles differed in HbA_1c groups, with a higher prevalence of comorbidities in the groups with higher HbA_1c levels. Median follow-up was 1,745 days (interquartile range 1,007-2,171). A J-shaped association curve was observed between HbA_1c levels and all-cause mortality rates, with patients in the lowest and highest HbA_1c groups suffering from significantly higher mortality rates compared to in-between groups (hazard ratio 1.9, 95% CI 1.32-2.74, p = 0.001, and hazard ratio 1.58, 95% CI 1.29-1.95, p < 0.001, for the lowest and highest HbA_1c groups, respectively). This association persisted after adjustment for anemia, nutritional status, renal function, cardiovascular risk factors and inflammatory biomarkers. Conclusions: HbA_1c levels <5 or >7% are predictors of all-cause mortality in patients undergoing coronary angiography.

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Vascular Complications of Diabetes Mellitus

Chiong¹,

Evans‐Molina²

2015

PanVascular Medicine

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Hemoglobin A1c as a prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction

Abstract: HbA1c is an independent predictor of the in-hospital mortality in STEMI treated with primary PCI. Apart from prognostic value, high HbA1c could be used for diabetes mellitus diagnosis, which is supported by ADA definitions.

Cited by 41 publications

References 0 publications

Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Prognostic value of glycated hemoglobin among patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

HbA<sub>1c</sub> Levels and Long-Term Mortality in Patients Undergoing Coronary Angiography

Vascular Complications of Diabetes Mellitus

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