Glycated hemoglobin level is an independent predictor of major adverse cardiac events after nonfatal acute myocardial infarction in nondiabetic patients

Chen, Chin Lan; Yen, David Hung Tsang; Lin, Chin; Tsai, Shih‐Hung; Chen, Sy‐Jou; Sheu, Wayne H.-H.; Hsu, Chin Wang

doi:10.1097/md.0000000000006743

Cited by 15 publications

(17 citation statements)

References 42 publications

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“…The two comparative studies are in accordance with this study and prove the theory that dyslipidemia and hypertension are risk factors for ACS. 13 The mean BMI in the group of subjects with ACS was 25.3 ± 2.7, significantly higher (p=0.006) than the mean BMI of the non ACS subject group (23.7 ± 2.3). The study conducted by Hartopo et al, (2016) with ACS subjects had mean BMI of 23.9 ± 3.2, it is almost the same as this study.…”

Section: Discussionmentioning

confidence: 78%

“…9 This study and the comparative research prove the theory that high BMI reflects the metabolic syndrome which is a risk factor for ACS. 10 HbA1c levels in the ACS group were higher (8.2) than in the non ACS group (7.7), but not significant (p=0.106).The study conducted by Chen et al, (2017) showed that the mean HbA1c levels in the CHD group were significantly higher than not CHD (5.91 ± 0.34 and 5.77 ± 0.36 with p = 0.012). 13 In this study it was found that the incidence of STEMI was higher, where the inferior STEMI (47.4%; 18 patients) was more than the anterior STEMI (28.9%; 11 patients), anteroseptal (13.2%; 5 patients) and NSTEMI (10.5%; 5 patients).The study conducted by Merza et al, (2016) stated that from the sample of 68 people, there were 40 STEMI samples.…”

Section: Discussionmentioning

confidence: 86%

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Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients

Wulansari

Soelistijo

Lefi

2019

BHSJ

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Introduction: Until now, cardiovascular complications are still the highest cause of death and disability in DM patients. Hypomagnesemia in DM accelerate atherosclerosis and can cause instability and plaque rupture which can lead to acute coronary syndrome.Methods: Design of this study was observational analytic using a "case control" study involved 76 samples of DM patients, consisting of 38 samples with SKA (+) and 38 samples with SKA (-). Subjects of this study were all DM patients in the period July-December 2018 in the Emergency Room (ER) and Outpatient Installation of Endocrine at the RSUD Dr. Soetomo Surabaya, which fulfills the criteria for inclusion and exclusion. Demographic data and clinical characteristics are presented descriptively. If data is normally distributed then an unpaired t test is carried out and if the data is not normally, distributed with Mann Whitney test is performed. The statistical test was stated to be significant if p <0.05. The association between hypomagnesemia and the incidence of ACS a multivariate logistic regression test was performed, the risk number was in the form of odds ratios (OR). Results: This study involved 76 subjects with diabetes mellitus with SKA and non SKA 38 subjects. The mean serum magnesium level in the ACS group was lower than non ACS (1.9 mg / dL vs. 2.1 mg / dL), hypomagnesemia cut-off of <2.08 mg / dL. In this study hypomagnesemia as a risk factor for the incidence of ACS in DM patients with OR 2.8 (CI 1.1-7.6; p = 0.039).Conclusion: Magnesium levels in the ACS group were lower than the non ACS group. Hypomagnesemia Increase The Incidence of Acute Coronary Syndrome in Diabetes Mellitus Patients.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 86%

Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients

Wulansari

Soelistijo

Lefi

2019

BHSJ

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“…Degradation of the glycocalyx alters endothelial barrier permeability and may thus cause damage to the microcirculation, which contributes to organ dysfunction [29][30][31]. Another study showed that HbA1c was a signi cant predictor of major adverse cardiac events after acute myocardial infarction (AMI) in nondiabetic patients [32]. Glycemic control may contribute to the damage to vascular structures caused by a poor glycemic status.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, poor glycemic control can lead to an increased formation of advanced glycation end products, which can cause severe vascular damage [33]. Therefore, HbA1c, which re ects metabolic control and embedded ongoing vascular injury or atherosclerosis, can be considered a reliable indicator of adverse outcomes in nondiabetic populations after AMI [32]. It should be noted that glucose level variability was greater in patients with high HbA1c than in those with normal HbA1c.…”

Section: Discussionmentioning

confidence: 99%

High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

Lee

Zuh

et al. 2020

Preprint

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Background: To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature management (TTM).Methods: This single-center retrospective cohort study included adult OHCA survivors who underwent hypothermic TTM from December 2011 to December 2019. High HbA1c at admission was defined as a level higher than 6%. Poor neurological outcomes were defined as cerebral performance category scores of 3-5. The primary outcome was 6-month mortality. The secondary outcome was the 6-month neurological outcome. Descriptive statistics, log-rank tests, and multivariable regression modeling were used for data analysis.Results: Of the 302 patients included in the final analysis, 102 patients (33.8%) had HbA1c levels higher than 6%. The high HbA1c group had significantly worse 6-month survival (12.7% vs. 37.5%, p < 0.001) and 6-month outcomes (89.2% vs. 73.0%, p = 0.001) than the non-high HbA1c group. Kaplan-Meier analysis and the log-rank test showed that the survival time was significantly shorter in the patients with HbA1c >6% than in those with HbA1c ≤6%. In the multivariable logistic regression analysis, HbA1c >6% was independently associated with 6-month mortality (OR 5.85, 95% CI 2.26-15.12, p < 0.001) and poor outcomes (OR 4.18, 95% CI 1.41-12.40, p < 0.001).Conclusions: This study showed that HbA1c higher than 6% at admission was associated with increased 6-month mortality and poor outcomes in OHCA survivors treated with hypothermic TTM. Poor long-term glycemic management may have prognostic significance after cardiac arrest.

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“…We are unaware of any large studies in South Africa that examined the prevalence and predictive value of admission blood glucose in patients presenting with AMI and our study may provide important epidemiological insight into elevated admission blood glucose as a risk factor for MACE. Although HbA1c, which reflects metabolic and glycaemic control, has been shown to be a significant predictor of MACE after AMI, (25) elevated admission blood glucose may serve as a cost-effective and easily obtainable alternate prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

Admission blood glucose as a prognostic indicator in patients with acute myocardial infarction

Russel¹,

Ranjith²,

Sartorius³

2019

SAHJ

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Objective: To investigate the utility of admission blood glucose for predicting major adverse cardiac events (MACE) during hospitalisation and 6 months' postdischarge in acute myocardial infarction (AMI) patients. Methods and results: This study recruited 2878 AMI patients admitted to the Coronary Care Unit at R. K. Khan Hospital, Durban, South Africa, from 2002 -2014. Demographic and clinical data stored in an electronic database were obtained from all patients. Admission blood glucose levels were sub-divided into 3 groups; low (<7.8), medium (7.8-10.9) and high (≥11) mmol/l. The mean age of the study population was 57.18 ± 7 years of whom 65% were males. Self-reported diabetes was found in 59%, while 377 patients were diagnosed with diabetes based on HbA1c levels ≥6.5%, increasing the overall prevalence to 72% (n=2070). More patients were in the low admission blood glucose group (49%), medium group (16%), and high group (35%). The highest prevalence of MACE was seen in the high group (42%) compared to either the medium (39%) or low groups (26%; p<0.001), particularly for cardiogenic shock (p<0.001), cardiac failure (p<0.001) and death (p<0.001). Following multivariable logistic regression analyses of clinical and laboratory parameters associated with mortality, high admission blood glucose conferred a signifi cantly increased odds of mortality (p=0.001). The optimal cut-off admission blood glucose value as determined via the receiver operating characteristic curve for predicting in hospital and 6 months' mortality was 8.5mmol/l (AUC of 0.63) and 8.1mmol/l (AUC of 0.61) for MACE. Conclusions: This study shows that patients have multiple risk factors for AMI with diabetes playing a central role. Although elevated admission blood glucose is an important predictor for in hospital and shortterm MACE, the cut-off value for predicting MACE and mortality has only modest predictability and further research is required to improve the performance of these measures for routine clinical use.

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Glycated hemoglobin level is an independent predictor of major adverse cardiac events after nonfatal acute myocardial infarction in nondiabetic patients

Cited by 15 publications

References 42 publications

Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients

Association between Serum Magnesium Level with Acute Coronary Syndrome (ACS) in Diabetes Mellitus (DM) Patients

High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

Admission blood glucose as a prognostic indicator in patients with acute myocardial infarction

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