Haemoglobin A_1c, acute hyperglycaemia and short‐term prognosis in patients without diabetes following acute ST‐segment elevation myocardial infarction

Abstract

Unlike acute hyperglycaemia, an elevated HbA(1c) level was not a risk factor for short-term outcomes in ST-segment elevation myocardial infarction patients without diabetes. Patients with acute hyperglycaemia and non-elevated HbA(1c) were associated with the worst prognosis. That suggests chronic glycaemic control/HbA(1c) level may help to recognize stress-induced hyperglycaemia and identify high-risk patients.

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

“…The value showed that the association between HbA 1c level and 30-day mortality were not significant when the cut-off value was 6.5%. It was noteworthy that all of the five studies [3,8,12,25,27] in the 6.5% group were conducted in Asia. As mentioned above, HbA 1c might not have significant prognostic value among Asian STEMI patients (Table 2).…”

“…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.…”

“…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.…”

“…However, it was proposed that hyperglycemia might be an index of stress-induced catecholamine release [7]. Hence, glucose level in the early phase of AMI would not necessarily reflect the preadmission glycaemic control [8]. On the contrary, glycated hemoglobin (HbA 1c ), a reflection of average blood glucose concentrations over the past 8-12 weeks, is less susceptible to stress during AMI.…”

Glycated Hemoglobin vs Fasting Plasma Glucose as a Predictor of Left Ventricular Dysfunction After ST-Elevation Myocardial Infarction

“…Although several previous studies showed conflicting results on the association between HbA1c and both short and long term mortality in STEMI patients with or without diabetes 3,18,20,21 , only 1 study to date has assessed the association between HbA1c and LV dysfunction on echocardiography. Salmasi and co-workers evaluated HbA1c and transmitral M A N U S C R I P T…”