The Relationship between Hemoglobin A1c and Major Adverse Cardiac Events in Nondiabetic Acute Myocardial Infarction Patients Underwent Primary Percutaneous Coronary Intervention

ABSTRACT

BACKGROUND AND OBJECTIVES: Hyperglycemia on hospital admission is a known important risk factor in patients with acute myocardial infarction. The purpose of this study was to investigate the relation between the level of hemoglobin A1c (HbA1c) and major adverse cardiac events (MACE) in non-diabetic acute myocardial infarction patients who underwent primary percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: Of the 105 acute myocardial infarction patients who underwent primary PCI between January 2002 and December 2002, 68 non diabetic patients were analyzed. The patients were divided into two groups group I (n=46, 58.7+/-12.5 years, 37 male) with low levels of HbA1c (<6%) and group II (n=22, 64.6+/-13.1 years, 18 male) with elevated levels of HbA1c (6% to 7%). MACE was observed during the six-month clinical follow-up. RESULTS: There were no differences in the risk factors for atherosclerosis and angiographic characteristics between the two groups. Group II had a significantly higher rate of MACE (13% vs. 36%, p=0.026) compared to Group I. Logistic regression analysis disclosed that an elevated level of HbA1c, between 6 and 7%, was a significant independent predictor of MACE. CONCLUSION: An elevated level of HbA1c is a significant prognostic factor in non-diabetic acute myocardial infarction patients after primary PCI.