• Chi Yuen Chan, Ruijie Li, Joseph Yat Sun Chan, Qing Zhang, Chin Pang Chan, Ming Dong, Bryan P Yan, Yat-Yin Lam, and Cheuk-Man Yu.
• Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
• Clin Cardiol. 2011 Aug 1;34(8):507-12.

BackgroundElevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A(1c) levels) in patients with ACS is still undefined.HypothesisHemoglobin A(1c) level may predict short-term outcome in patients with ACS.MethodsWe conducted a retrospective study with prospective follow-up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA(1c) level, checked within 8 weeks of the index admission (optimal control group, HbA(1c) ≤7%; suboptimal control group, HbA(1c) >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short-term clinical outcomes were also compared between the 2 study groups.ResultsIn our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction, respectively. In-hospital mortality was similar in both HbA(1c) groups (3.37% vs 2.88%, P = 0.803). Six-month MACE was also similar (26.40% vs 26.47%, P = 0.919). All-cause mortality, cardiovascular mortality, symptom-driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6-month MACE and individual endpoints were also similar in both groups.ConclusionsThis study suggests that HbA(1c) levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS.© 2011 Wiley Periodicals, Inc.

50 keywords...

hide…