Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion

Ahn, Jinhee; Hong, Taek Jong; Park, Jin Sup; Lee, Hye Won; Oh, Jun-Hyok; Choi, Jung Hyun; Lee, Han Cheol; Soo, Kwang; Yun, Eun Young; Jeong, Myung Ho; Chae, Shung Chull; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Jang, Yang Soo; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Rha, Seung Woon; Bae, Jang Ho; Park, Seung Jung

doi:10.1097/mca.0000000000000258

Cited by 3 publications

(4 citation statements)

References 31 publications

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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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“…37 Similarly, higher levels of follow-up HbA 1c are associated with increased 12-month MACE rates in patients with diabetes and STEMI after reperfusion. 50…”

Section: Resultsmentioning

confidence: 99%

“…37 Similarly, higher levels of follow-up HbA 1c are associated with increased 12-month MACE rates in patients with diabetes and STEMI after reperfusion. 50 In conclusion, patients with some form of glucose intolerance are at higher risk of mortality after an ACS than those with normal glucose tolerance. Admission plasma glucose plays a role in predicting adverse events, especially in subjects with previously unknown diabetes.…”

Section: Question 1: Are Admission Glucose and Glycated Haemoglobin Pmentioning

confidence: 88%

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Avogaro

Bonora

Consoli

et al. 2019

Diabetes and Vascular Disease Research

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Diabetes is a common comorbidity in patients hospitalized for an acute coronary syndrome event, and prevalence is increasing. Among patients hospitalized with acute myocardial infarction, diabetes can be an independent predictor of mortality and new cardiovascular events; both short- and long-term outcomes are worse for patients with diabetes relative to those without, and undiagnosed diabetes is associated with greater mortality. The impact of glycemic control on cardiovascular outcomes and the best approach to treat hyperglycemia upon hospital admission for acute coronary syndrome in patients with or without known diabetes remain open questions. This review assesses available evidence for hyperglycemia management at the time of admission for acute coronary syndrome and, thereafter, finds that (1) admission plasma glucose plays a role in predicting adverse events, especially in patients with unknown diabetes; (2) glycated haemoglobin is a likely predictor of events in patients with unknown diabetes; and (3) hypoglycemia at the time of acute myocardial infarction hospital admission is an important predictor for mortality in patients with and without diabetes. Whether glucose-targeted insulin and glucose infusion have advantages over glucose–insulin–potassium infusion remains controversial. Evidence for the effect of novel glucose-lowering agents used at the time of an acute cardiovascular event is limited and requires more dedicated studies.

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Glycosylated hemoglobin at early follow-up and outcome in diabetic patients with ST-segment elevation myocardial infarction

Ndrepepa

2015

Coronary Artery Disease

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Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion

Cited by 3 publications

References 31 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

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Glycosylated hemoglobin at early follow-up and outcome in diabetic patients with ST-segment elevation myocardial infarction

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