Two-year prognosis of admission hemoglobin A1c following a primary percutaneous coronary intervention

Abstract

Objective: We sought to assess the effect of hemoglobin A1c (HbA1c) on the outcomes of a primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).

Background: Many studies have shown the diagnostic and predictive value of HbA1c levels in patients with acute myocardial infarction. We assessed the prognostic role of HbA1c in short-term and long-term mortality in 796 consecutive patients with STEMI.

Methods and results: A total of 796 patients with STEMI undergoing primary PCI were prospectively enrolled between December 2013 and June 2015. The patients were divided into three groups on the basis of admission HbA1c levels: group I (HbA1c≤5.6%), group II (HbA1c 5.7-6.4%), and group III (HbA1c≥6.5%). The in-hospital and 2-year cardiovascular (CV) mortality and morbidity of all three patient groups were followed up. A significant association was found between HbA1c level and 2-year primary clinical outcomes, including CV mortality, heart failure/shock, and major adverse cardiovascular event (P<0.001).

Conclusion: HbA1c is an independent predictor of the in-hospital and long-term mortality, nonfatal reinfarction, and target vessel revascularization in STEMI patients treated with primary PCI.