Influence of admission blood glucose and hemoglobin A1c on outcome of acute myocardial infarction

Zaghla, Hanan; El-Badry, Mahmoud A.; Ashour, Alaa; Abdelfatah, Mohamed M.

doi:10.4103/1110-7782.132895

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…After 6 months, there was no significant difference in mortality between both groups (p = 0.09). This was in agreement with Zaghla et al 12 who reported that HbA1c level was not found to be correlated with 6 months mortality.…”

Section: Discussionsupporting

confidence: 93%

The effect of elevated glycated hemoglobin on in-hospital and short-term outcome of patients with acute anterior myocardial infarction

Ibrahim-Farag¹,

El-Rabbat²,

Mansour³

et al. 2022

RCCAR

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Introduction: Hyperglycemia has a negative impact on morbidity and mortality among patients with acute myocardial infarction (AMI). Objective: The objective of the study was to evaluate the impact of chronic hyperglycemia on in-hospital and short-term outcome in patients with acute anterior MI treated with streptokinase as thrombolytic therapy. Materials and methods: A total of 100 patients with acute anterior myocardial infarction received streptokinase as thrombolytic therapy were enrolled. They were classified according to the admission glycated hemoglobin (HbA1c) level into two groups: Chronic hyperglycemic group (HbA1c ≥ 6.5%) (36 patients) and non-chronic hyperglycemic group (HbA1c <6.5%) (64 patients). Laboratory investigation, conventional echocardiography, and speckle tracking were performed. Results: Global longitudinal strain (GLS) was significantly lower in patients with chronic hyperglycemia group compared to non-chronic hyperglycemia group (−13.52 ± 4.83 vs. −15.27 ± 1.87%, p = 0.009). In-hospital outcome: Heart failure and reinfarction were significantly increased in patients with chronic hyperglycemia (45.5 vs. 16.7% and 18.2 vs. 3.3%, respectively, p < 0.05). Six months outcome: Heart failure, left ventricular (LV) remodeling, arrhythmias, and bleeding rates were significantly increased in patients with chronic hyperglycemia

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Section: Discussionsupporting

confidence: 93%

The effect of elevated glycated hemoglobin on in-hospital and short-term outcome of patients with acute anterior myocardial infarction

Ibrahim-Farag¹,

El-Rabbat²,

Mansour³

et al. 2022

RCCAR

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“…showed that elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome; however, the prognostic value of HbA 1 c levels in these patients is still undefined. [ 26 ] The results of ADVANC study showed that a less marked reduction in HbA1c levels (i.e., from 7.5% to 6.5%) was associated with a significant reduction of major vascular events and a nonsignificant beneficial trend in mortality. [ 27 ] On the other hand, the Action to Control Cardiovascular Risk in Diabetes study showed that a higher baseline level of HbA 1 c and greater reduction in its levels appeared to be associated with increased risk in the ambulatory setting, similar to the acute setting.…”

Section: Discussionmentioning

confidence: 99%

Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

Mahmoodpoor

Hamishehkar

Shadvar

et al. 2016

Indian Journal of Critical Care Medicine

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Background and Aims:The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM). In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU) admission blood glucose and glucose control during ICU stay with mortality in critically ill patients.Materials and Methods:Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c) concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients.Results:Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001). Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004–1.02, relative risk [RR]: 1.01). Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933–1.58, RR: 1.2).Conclusions:Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia.

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“…Egypt has nearly 100 million people who have special demographic and social characteristics which increase the possibility of the stress-induced conditions and its health-associated problems; some of these characteristics may be shared with other developing nations. Previous Egyptian studies confirmed that elevated admission glucose level is a strong predictor of short-term adverse outcomes in patients with AMI but no previous studies in our country regarding the impact of AH on AAR, FIS, or SI which is the major concept of our research [10,11]. An Indian study had addressed the association of AHG and increased myocardial damage evidenced by cardiac biomarkers and echocardiographic derived data but without using CMR modality.…”

Section: Discussionmentioning

confidence: 87%

Unique role of admission hyperglycemia on myocardial infarction size and area at risk following an acute ST-elevation myocardial infarction

et al. 2020

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Background Hyperglycemia can adversely affect patients with acute ST-elevation myocardial infarction (STEMI) in both diabetic and non-diabetic patients. The majority of the studies had investigated the impact of admission hyperglycemia (AH) on cardiovascular morbidity and mortality while, in ours, we entailed its impact on final infarction size (FIS) and more interestingly, on the area at risk (AAR), both were estimated by cardiac magnetic resonance (CMR) imaging. Results AH showed significant positive correlations to FIS and AAR. Moreover, AH group had higher summation of ST segment elevation (sum STE), more maximum ST segment elevation (max STE), higher echocardiographic wall motion score index (WMSI), higher CMR estimated WMSI, and lower segmental ejection fraction (EF). Multivariate analysis showed that AH was independently associated with increased FIS. Conclusion Current study showed an association between AH and large FIS in STEMI patients.

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Influence of admission blood glucose and hemoglobin A1c on outcome of acute myocardial infarction

Abstract: Aim of the studyWe aimed at studying a population of unknown diabetes mellitus with AMI to evaluate the effect of their admission blood glucose and glycated hemoglobin on their prognosis.

Cited by 5 publications

References 16 publications

The effect of elevated glycated hemoglobin on in-hospital and short-term outcome of patients with acute anterior myocardial infarction

The effect of elevated glycated hemoglobin on in-hospital and short-term outcome of patients with acute anterior myocardial infarction

Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients

Unique role of admission hyperglycemia on myocardial infarction size and area at risk following an acute ST-elevation myocardial infarction

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