Article

Glucose abnormalities are frequent comorbidities influencing
prognosis in patients with cardiovascular diseases.
The objective of this study
was to evaluate prognostic role of HbA1c in patients with acute myocardial
infarction (AMI) treated invasively, who had newly detected glucose
abnormalities. DESIGN: Single-centre registry encompassed 2146 survivors of AMI.
In all patients without diabetes mellitus (DM), oral glucose tolerance test was
performed before hospital discharge and interpreted according to the guidelines.
METHODS: From the study population, two major groups with defined new glucose
abnormalities and estimated HbA1c were selected: 457 patients with impaired
glucose tolerance (IGT) and 306 patients with newly detected DM (newDM). In each
of these groups, the median value of HbA1c was calculated and established as the
cut-off point for further analysis. The median HbA1c for IGT group was 5.9% and
for newDM was 7.0%. RESULTS: Patients with IGT and HbA1c </= 5.9% had
significantly lower posthospital mortality (4.5%) than those with HbA1c >5.9%
(25.0%; p<0.001). Similarly, patients with newDM and HbA1c </=7.0% had lower
mortality (6.4%) than those with HbA1c >7.0% (14.3%; p<0.05). Multivariate
regression analysis revealed that increase of HbA1c was one of the strongest
independent risk factors of death among IGT patients (HR 2.9, 95% CI 2.7-3.1; p <
0.001) and newDM (HR 1.53, 95% CI 1.39-1.66; p<0.05). CONCLUSIONS: Increase of
HbA1c in patients with newly detected glucose abnormalities was associated with
significantly reduced survival after AMI treated invasively. Moreover, increase
of HbA1c in patients with IGT and newDM was one of the strongest independent risk
factors of death in these populations.
CI - (c) The European Society of Cardiology 2014 Reprints and permissions:
sagepub.co.uk/journalsPermissions.nav.

Langue : ANGLAIS