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. 2008 May;24(5):375-8.
doi: 10.1016/s0828-282x(08)70600-7.

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

Mahmut Cakmak  1 , Nazmiye Cakmak, Sebnem Cetemen, Halil Tanriverdi, Yavuz Enc, Onder Teskin, I Dogu Kilic
Affiliations

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

Mahmut Cakmak et al. Can J Cardiol. 2008 May.

Abstract
in English, French

Background: Glycosylated hemoglobin (HbA1c) level on admission is a prognostic factor for mortality in patients with and without diabetes after myocardial infarction. In the present study, the authors examined the relationship between admission HbA1c level and myocardial perfusion abnormalities in patients with acute myocardial infarction.

Methods: One hundred consecutive patients with acute myocardial infarction who were treated with thrombolytic therapy were included in the present prospective study. Blood glucose and HbA1c levels of all patients were measured within 3 h of admission. Patients were divided into three groups according to HbA1c level: 4.5% to 6.4% (n=25), 6.5% to 8.5% (n=28) and higher than 8.5% (n=47). All patients then underwent exercise thallium-201 imaging and coronary angiography to determine ischemic scores and the number of diseased coronary arteries four weeks after admission.

Results: Seven patients died within the four-week follow-up period. There was a significant relationship between admission HbA1c level and mortality (P=0.009). Furthermore, there was a significant relationship between HbA1c level and total ischemic scores in patients with acute myocardial infarction (r=0.482; P=0.001). Ischemic scores increased as HbA1c levels increased in patients with acute myocardial infarction.

Conclusions: The results demonstrated that admission plasma glucose and HbA1c levels are prognostic factors associated with mortality after acute myocardial infarction.

HISTORIQUE :: Le taux d’hémoglobine glycosylée (HbAlc) au moment de l’hospitalisation est un facteur pronostique chez les patients diabétiques ou non diabétiques après un infarctus du myocarde. Dans la présente étude, les auteurs ont examiné la relation entre le taux de HbAlc à l’hospitalisation et les anomalies de perfusion myocardique chez les adultes atteints d’un infarctus aigu du myocarde.

MÉTHODOLOGIE :: Cent patients consécutifs atteints d’un infarctus aigu du myocarde recevant un traitement thrombolytique faisaient partie de la présente étude prospective. La glycémie et les taux de HbAlc de tous les patients ont été mesurés dans les trois heures suivant leur hospitalisation. Les patients ont été divisés en trois groupes, selon leur taux de HbAlc : de 4,5 % à 6,4 % (n=25), de 6,5 % à 8,5 % (n=28), et plus de 8,5 % (n=47). Tous les patients ont ensuite subi une imagerie d’épreuves d’effort au thallium 201 et une coronarographie pour déterminer les indices ischémiques et le nombre d’artères coronaires atteintes quatre semaines après l’hospitalisation.

RÉSULTATS :: Sept patients sont décédés pendant la période de suivi de quatre semaines. On a constaté un lien significatif entre le taux de HbAlc à l’hospitalisation et la mortalité (P=0,009). Le lien était également significatif entre le taux de HbAlc et les indices ischémiques totaux chez les patients atteints d’un infarctus aigu du myocarde (r=0,482; P=0,001). L’augmentation des indices ischémiques était proportionnelle aux taux de HbAlc chez les patients atteints d’un infarctus aigu du myocarde.

CONCLUSIONS :: Les résultats démontrent que les taux de glucose plasmatique et de HbAlc à l’hospitalisation sont des facteurs pronostiques de la mortalité après un infarctus aigu du myocarde.

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Figures

Figure 1)
Figure 1)
Box plots of total ischemic scores according to glycosylated hemoglobin (HbA1c) levels
Figure 2)
Figure 2)
The correlation between glycosylated hemoglobin (HbA1c) levels and total ischemic scores in patients with acute myocardial infarction
See this image and copyright information in PMC

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