[Prognostic value of HbA1c and plasma glucose on one-year mortality in non-diabetic patients after myocardial infarction]. / Impact pronostique de l'HbA1c et de la glycémie plasmatique (Gp) à la phase aiguë d'un infarctus du myocarde sur la mortalité à un an chez des patients non diabétiques.
Ann Cardiol Angeiol (Paris)
; 69(4): 180-191, 2020 Oct.
Article
en Fr
| MEDLINE
| ID: mdl-32854906
ABSTRACT
BACKGROUND:
The usefulness of the combined assessment of HbA1c and plasma glucose (PG) in acute myocardial infarction (AMI) in non-diabetic patients remains unclear.PURPOSE:
In a large observational study, we aimed to identify the prognostic values of these biomarkers regarding one-year all-cause mortality in non-diabetic patients after AMI.METHODS:
From the "obseRvatoire des Infarctus de Côte d'Or" (RICO) survey database, we included all consecutive non-diabetic patients with AMI (n=6617) from May 2001 to December 2016. Exclusion criteria were admission known or unknown diabetes, in-hospital death. The primary endpoint was all-cause one-year mortality. The secondary endpoints were MACE, infarct size, LVEF<40% and GRACE risk score. Cut-off levels (high/low) were determined by ROC curve analysis for the prediction of one-year death (HbA1c 5.9% and PG 131mg/dL) to set up 4 groups low HbA1c/low glucose (n=3158), low HbA1c/high glucose (n=1264), high HbA1c/low glucose (n=1378) and high HbA1c/high glucose (n=817).RESULTS:
Elevation of PG was associated with elevated rate of LVEF<40%, STEMI, anterior wall location, DFG<60mL/min/m2 and higher troponin Ic pic (all P<0.001); HbA1c>5.9% was associated with elevated rate of CRP>3mg/L (P<0.001); high HbA1c and high PG together were associated with higher rate of MACE (P<0.001). By multivariate logistic regression analysis, elevated admission PG remained a strong predictor of one-year all-cause [OR (95%CI) 1.64 (1.31-2.05)] mortality and cardiovascular mortality [OR (95%CI) 1.75 (1.33-2.31)], beyond GRACE score [OR (95%CI) 1.03 (1.03-1.04)], as well as elevated HbA1c [OR (95%CI) 1.43 (1.15-1.78) and OR (95%CI) 1.83 (1.39-2.41) respectively].CONCLUSIONS:
Admission PG and HbA1c had strong independent predictive value regarding one-year all-cause mortality in our non-diabetic patients with AMI. These biomarkers could be useful to identify the most-at-risk patients after AMI in order to reduce residual risk in this target population.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_cardiovascular_diseases
/
6_ischemic_heart_disease
Asunto principal:
Glucemia
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Hemoglobina Glucada
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Infarto del Miocardio
Tipo de estudio:
Clinical_trials
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Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
Fr
Revista:
Ann Cardiol Angeiol (Paris)
Año:
2020
Tipo del documento:
Article
País de afiliación:
Francia