PMID- 24297265
OWN - NLM
STAT- MEDLINE
DCOM- 20141201
LR  - 20221207
IS  - 1613-7671 (Electronic)
IS  - 0043-5325 (Linking)
VI  - 126
IP  - 5-6
DP  - 2014 Mar
TI  - Hemoglobin A1c is a better predictor of prognosis following the non-ST elevation 
      acute coronary syndrome than fasting and admission glucose.
PG  - 156-62
LID - 10.1007/s00508-013-0468-2 [doi]
AB  - BACKGROUND: Glucometabolic status is an important predictor of prognosis in 
      patients with acute myocardial infarction. Both plasma glucose levels and 
      glycosylated hemoglobin A1c (HbA1c) were implicated as predictors of prognosis. 
      However, previous data yielded conflicting results. We evaluated the prognostic 
      role of plasma glucose levels and HbA1c in patients with non-ST elevation acute 
      coronary syndrome (NSTEACS). METHODS: A total of 106 consecutive patients with 
      NSTEACS (55 with unstable angina and 51 with non-ST elevation myocardial 
      infarction) were included. The average age was 66.1 years; 61% were male. HbA1c 
      was measured at admission, along with other standard laboratory values. The 
      follow-up period lasted for a year. The main combined outcome variable included 
      death from cardiovascular causes and rehospitalization due to another acute 
      coronary syndrome or due to heart failure. RESULTS: Combined end point occurred 
      in 43 (41%) patients. Mean HbA1c value was significantly higher in the group of 
      patients who had complications (7.6 +/- 2.6 vs. 5.8 +/- 1.2, p < 0.05). Logistic 
      regression identified HbA1c [odds ratio (OR): 1.6] and male sex (OR: 0.25) as the 
      only independent predictors of major adverse cardiac events (MACE). A 
      Kaplan-Meier analysis showed a 2.7 times higher risk of MACE in patients with 
      HbA1c > 6.5%. CONCLUSIONS: Results from our study indicate that the admission 
      level of HbA1c, but not admission or fasting glucose, is a predictor of mortality 
      and major adverse events in patients with NSTEACS. These results identify HbA1c 
      to be an independent predictor also in patients with NSTEACS, and not only in 
      those with ST elevation myocardial infarction as observed before our study.
FAU - Kmet, Marko
AU  - Kmet M
AD  - Medical Intensive Care Unit, Novo mesto General Hospital, Novo mesto, Slovenia.
FAU - Rajer, Borut
AU  - Rajer B
FAU - Pernat, Andrej
AU  - Pernat A
LA  - eng
PT  - Journal Article
DEP - 20131203
PL  - Austria
TA  - Wien Klin Wochenschr
JT  - Wiener klinische Wochenschrift
JID - 21620870R
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Acute Coronary Syndrome/*blood/mortality
MH  - Aged
MH  - Angina, Unstable/blood/mortality
MH  - Austria
MH  - Blood Glucose/*metabolism
MH  - Coronary Care Units
MH  - Diabetes Mellitus, Type 2/blood/mortality
MH  - Fasting
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/*metabolism
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/mortality
MH  - Patient Admission
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
EDAT- 2013/12/04 06:00
MHDA- 2014/12/15 06:00
CRDT- 2013/12/04 06:00
PHST- 2013/02/23 00:00 [received]
PHST- 2013/11/06 00:00 [accepted]
PHST- 2013/12/04 06:00 [entrez]
PHST- 2013/12/04 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 10.1007/s00508-013-0468-2 [doi]
PST - ppublish
SO  - Wien Klin Wochenschr. 2014 Mar;126(5-6):156-62. doi: 10.1007/s00508-013-0468-2. 
      Epub 2013 Dec 3.