Prognostic effect of glycated hemoglobin in acute myocardial infarction

Abstract

Background Impaired glucose tolerance and even prediabetic states have a crucial role as risk factors among several different risk factors in acute myocardial infarction (AMI). Some recent studies have shown that poor diabetes management, diagnosed by glycated hemoglobin (HbA1C), has poor prognostic value regarding future cardiovascular events, whereas other studies recommend that it is the blood glucose level at admission that predicts short-term mortality after AMI and not the HbA1C level. Aim The target of this research is to detect the correlation between the level of HbA1C and risk factors in the patients with AMI and its value regarding the severity of coronary lesions and prognosis. Patients and methods A total of 80 consecutive patients presenting with ST elevation MI to the National Heart Institute and treated with primary percutaneous coronary intervention represented the target population. Patients were classified inconsistent with HbA1C level into three groups: group 1: HbA1C less than 5.7%, group 2: HbA1C 5.7–6.4%, and group 3: more than 6.4%. Comparison among the three groups was done regarding the risk factors, troponin level, blood glucose level, lipid profile, kidney function, number of affected vessels, length of the stented area, type of MI, EF, morbidity, and mortality. Results Our results showed that regarding risk factors, diabetes and hypertension were significantly more common in group 3 as compared with the other two groups. Patients in group 3 also had significant elevated admission blood glucose. No other significant difference was noted among the three groups. Conclusion Our result suggests that in spite diabetes being a major risk factor for atherosclerotic coronary artery disease, HbA1C level has no correlation with severity and short-term prognosis.

Keywords

• diabetes mellitus
• glycated hemoglobin
• primary percutaneous coronary intervention
• st elevation myocardial infarction