Effect of hemoglobin A1c change on 24-month clinical outcomes in patients with diabetes after acute myocardial infarction.
Coron Artery Dis
; 35(6): 465-470, 2024 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-38682470
ABSTRACT
BACKGROUND:
The average glycated hemoglobin (HbA1c) may not accurately reflect glycemic control status during the mid-term after acute myocardial infarction (AMI). We aimed to evaluate changes in HbA1c and their effect on mid-term clinical outcomes in patients with diabetes and AMI.METHODS:
We enrolled patients with diabetes ( n â =â 967) who underwent HbA1c measurement in the Korean nationwide registry. These patients were categorized into three groups based on changes in HbA1c from index admission to the 1-year follow-up visit a decrease in HbA1câ >â 1%, changes in HbA1c within 1%, and an increase in HbA1câ >â 1%. Clinical outcomes at 24 months were examined.RESULTS:
The baseline HbA1c levels were 8.55â ±â 0.85, 7.00â ±â 0.98 and 7.07â ±â 1.05 ( P â =â 0.001) and HbA1c levels after 1 year were 6.62â ±â 0.73, 7.05â ±â 0.98 and 9.26â ±â 1.59 ( P â =â 0.001) for patients with 3 groups, respectively. Patients with a 1% decrease in HbA1c had significantly lower incidence of major adverse cardiovascular events (MACE), cardiac death, and rehospitalization after 24 months than those with a 1% increase in HbA1c. However, in the Cox regression analysis, a >1% decrease in HbA1c change was not an independent factor for MACE, cardiac death, and rehospitalization.CONCLUSIONS:
Our analysis indicates that an HbA1c decrease of >1% within the first 12 months was not an independent prognostic factor until the 24-month mark. Therefore, standard diabetic control is recommended for patients with diabetes and AMI for up to 2 years.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas Glicadas
/
Biomarcadores
/
Sistema de Registros
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Diabetes Mellitus
/
Infarto do Miocárdio
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article