The relationship of hospital admission and fatality from myocardial infarction to glycohaemoglobin levels

Abstract

We have performed a study to assess the relative contributions of increased hospital admission rates with acute myocardial infarction and increased hospital case fatality to the excess mortality of subjects with elevated levels of glycohaemoglobin from myocardial infarction. Glycohaemoglobin levels were estimated by isoelectric focussing in 397 subjects without known diabetes mellitus admitted with myocardial infarction and compared with a control population reconstructed from a community sample of 1084 subjects without known diabetes mellitus screened in general practice. In the case-control comparison, glycohaemoglobin levels above the 90th centile were associated with relative risks of 3.1 (95% confidence interval 1.4-6.8) for admission with myocardial infarction and 5.3 (95% confidence interval 2.1-13.4) for death in hospital. Elevated glycohaemoglobin on admission was a predictor of both death and cardiac pump failure among those admitted with myocardial infarction, as was the presence of known diabetes. In those over 40 years of age, the top 1% of the glycohaemoglobin distribution contribute 4.3% of admissions and 9.6% of hospital deaths with myocardial infarction.

Prognostic value of admission plasma glucose and HbA1c in acute myocardial infarction

“…Our study population was unselected and its characteristics were similar to those used in previously published reports. The mean age and sex ratio were similar to those of the patients included in the Yudkin's study [16]. Previously diagnosed diabetes was as frequent in our cohort (about 20%) as in other cohorts studying patients with recent acute myocardial infarction such as USIK [17] or EUROASPIRE [18].…”

Prognostic value of HbA1c for in-hospital and short-term mortality in patients with acute coronary syndrome: a systematic review and meta-analysis

“…Fifteen studies referred HbA1c as a categorial valuable [16–30], and showed that when compared to lower HbA1c groups, higher HbA1c was significantly associated with increased in-hospital mortality (RR: 1.285, 95% CI 1.148–1.439, p: 0.000, I 2 = 71.9%, n = 15) (Fig. 2a).…”

Elevated glycated haemoglobin in non-diabetic patients is associated with an increased mortality in myocardial infarction

“…4 The aim of this study was to determine whether HbAlc levels at presentation of AMI had an influence on the short-term outcome in non-diabetic subjects.…”