Heart India (Jan 2016)
Prognostic significance of glycosylated hemoglobin in nondiabetic patients in acute coronary syndrome
Abstract
Background: The role of glycosylated hemoglobin (HbA1c) in predicting the outcome of acute coronary syndrome (ACS) remains largely controversial. Much lesser is known of its importance in nondiabetics. Herein, we conducted a study to seek the association between the levels of HbA1c and the clinical outcome in nondiabetic patients who presented with ACS. Objective: The objective was to determine the impact of HbA1c levels on the severity and complications of ACS in nondiabetics. Materials and Methods: This observational cross-sectional study included 100 patients without diabetes mellitus who were admitted to the coronary care unit with symptoms suggestive of ACS. The diagnosis of ACS was made on the basis of troponin T value, electrocardiogram (ECG), and echocardiograph. Patients were stratified according to their HbA1c into two groups: Group 1 HbA1c <5.6 (36, 36%), Group 2 HbA1c between 5.7 and 6.4 (64, 64%). Main outcome measures were ECG changes (ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction), troponin T value, regional wall motion abnormalities and left ventricular ejection fraction on echo, along with the complications such as heart failure and arrhythmias. Data were analyzed separately using multiple regression analysis. Results: The mean age of patients was 58.67 years out of which 69% were males and 31% females. Of the total, 28% were smokers, 33% were known to be hypertensive, 32% had dyslipidemia, and body mass index was ≥25 kg/m2 in 9% of the subjects. The findings of this study found that increased levels of HbA1c were in general, associated with poorer outcomes in the nondiabetics. Conclusion: HbA1c is a predictor of major adverse outcomes in ACS in patients even when they are nondiabetics. Measurement of HbA1c levels may improve risk assessment in such patients when presenting with ACS.
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