Prognostic value of admission plasma glucose and HbA_1c in acute myocardial infarction

Abstract

Admission plasma glucose, even after adjustment on HbA(1c), is a prognostic factor associated with mortality after acute myocardial infarction. Acute rather than the chronic pre-existing glycometabolic state accounts for the prognosis after acute myocardial infarction.

Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia

“…Although a near‐linear relationship between higher admission glucose levels and worse outcome has been reported consistently in AMI patients without DM,25, 26 such an association has not been clearly established in DM patients 15, 27, 28. Moreover, although HbA 1c is a useful tool in assessing average glucose control in the outpatient setting, it has limited prognostic value in predicting in‐hospital mortality rates in AMI patients 29, 30…”

The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction

“…While hyperglycemia is a marker of post AMI stress; insulin resistance is related to the intensity of the stress (12). A chronic preexisting abnormal glycometabolic state inevitably affects the degree of metabolic response to stress; higher blood glucose levels were found during stress in patients with previously known IGT.…”

“…AMI patients without established diabetes had a high prevalence of insulin resistance during the hospital phase and the following three months (2). Hadjadj et al (12) recently reported that admission plasma glucose, even after adjusting for HbA1c, is a prognostic factor associated with mortality after AMI. Acute, rather than the chronic, pre-existing glycometabolic states accounted for the prognosis after AMI.…”

“…Patients in group 1 were accepted as nondiabetic, patients in group 2 as possibly diabetic and patients in group 3 as diabetic, regardless of whether it was known previously (12).…”

Blood glucose and its prognostic implications in patients hospitalised with acute myocardial infarction

“…While glycosylated haemoglobin (HbA 1C ) is useful in assessing average glucose control, and has clear prognostic implications in the outpatient setting, 37 its value in predicting outcomes in the setting of hospitalisation for AMI is limited. 20,38 Therefore, there is a need for a summary measure of inpatient glucose control ("in-hospital HbA 1C ") that would take into account multiple and random glucose measurements obtained at various times and intervals, representing various nutritional conditions, and have a demonstrated impact on patient outcomes.…”