Prognostic value of admission glucose and glycosylated haemoglobin levels in acute coronary syndromes

QJM : Monthly Journal of the Association of Physicians
Jorik R TimmerFelix Zijlstra

Abstract

Admission hyperglycaemia is associated with poorer prognosis in patients with an acute coronary syndrome (ACS). Whether hyperglycaemia is more important than prior long-term glucose metabolism, is unknown. To investigate the prognostic value of admission glucose and HbA(1c) levels in patients with ACS. We measured glucose and HbA(1c) at admission in 521 consecutive patients with suspected ACS. Glucose was categorized as <7.8 (n = 305), 7.8-11.0 (n = 138) or > or =11.1 mmol/l (n = 78); HbA(1c) as <6.2% (n = 420) or > or =6.2% (n = 101). Mean follow-up was 1.6 +/- 0.5 years. The diagnosis of ACS was confirmed in 332 patients (64%), leaving 189 (36%) with atypical chest pain. In ACS patients, mortality by glucose category (<7.8, 7.8-11.0 or > or =11.1 mmol) was 9%, 8% and 25%, respectively (p = 0.001); mortality by HbA(1c) category (<6.2% vs. > or =6.2%) was 10% vs. 17%, respectively (p = 0.14). On multivariate analysis, glucose category was significantly associated with mortality (HR 3.0, 95% CI 1.1-8.3), but HbA(1c) category was not (HR 1.5, 95%CI 0.6-4.2). Elevated admission glucose appears more important than prior long-term abnormal glucose metabolism in predicting mortality in patients with suspected ACS.

Citations

Jun 15, 2007·Current Opinion in Clinical Nutrition and Metabolic Care·Mercedes Falciglia
May 15, 2010·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Violeta MladenovićMirko Rosić
Nov 26, 2013·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Yaron ArbelShmuel Banai
Feb 26, 2014·Clínica e investigación en arteriosclerosis : publicación oficial de la Sociedad Española de Arteriosclerosis·Ebrey León-AlizMagda A Rabassa-López-Calleja
Sep 28, 2010·Nutrition·Sarah Dawn Corathers, Mercedes Falciglia
Oct 2, 2007·Annales d'endocrinologie·L RoszykI Tauveron
Nov 17, 2009·Journal of Critical Care·Ivan GornikVladimir Gasparović
May 5, 2007·Diabetes Research and Clinical Practice·Patrícia Tolledo MacielBeatriz D'Agord Schaan
Jul 1, 2011·Clinical Cardiology·Chi Yuen ChanCheuk-Man Yu
Mar 29, 2014·European Heart Journal. Acute Cardiovascular Care·Maria L BlascoJuan Sanchis
Apr 3, 2016·European Heart Journal. Acute Cardiovascular Care·Kirill ButurlinDavid Pereg
Dec 1, 2007·Journal of the Royal Society of Medicine·Khairollah AsadollahiGeoffrey Gill
Feb 25, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahito MiuraHaruka Sato

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