Determination of HbA1c concentrations in patients with acute myocardial infarction: comparison of the DCA 2000 device with the HPLC method.
BACKGROUND
Recent studies suggest that HbA1c is an important predictor of the glycometabolic state of patients admitted for acute myocardial infarction (AMI).


OBJECTIVE
We aimed at comparing the results of HbA1c concentrations obtained by 2 different methods in patients with AMI.


METHODS
In a first study, HbA1c was measured in all patients consecutively hospitalized for AMI, during a 6 month period using the HPLC method and the DCA 2000 device in the biochemistry laboratory. In a second study, HbA1c measured by the DCA 2000 device in the intensive care unit was compared with HbA1c determined by HPLC in the biochemistry laboratory in a similar sample of patients. In patients without personal history of diabetes, those patients with HbA1c > 6.5% (HPLC method), were classified as possible diabetes.


RESULTS
A total of 146 patients were included (119 males, 27 females; mean age: 63 +/- 15 years). Twenty-seven of the patients had a personal history of diabetes. HbA1c determined by 2 techniques were highly correlated (r = 0.939, P < 0.0001). The mean of the differences (Bland and Altman analysis) was 0.4 +/- 0.3%. Compared with the HPLC method, the sensitivity of DCA 2000 device for the detection of possible diabetes was 81.8 +/- 11.6 and the specificity was 99.1 +/- 0.9%. The diagnostic accuracy of DCA method was 97.5 +/- 1.4%. In the second study, the HbA1c concentrations of 21 additional subjects, determined in an intensive care unit, were not different from the first 21 patients of the first study.


CONCLUSIONS
HbA1c can be effectively determined using the DCA 2000 device. This method is reliable and easy to be implemented in an intensive care unit.
Hadjadj
S
S
Endocrinology, Diabetology Department, University Hospital, BP 577, 86021 Poitiers Cedex, France. s.hadjadj@chu-poitiers.fr
Duengler
F
F
Barriere
M
M
Mauco
G
G
Coisne
D
D
Warnier
F
F
Sosner
P
P
Torremocha
F
F
Herpin
D
D
Marechaud
R
R
D001322:Autoanalysis; D001786:Blood Glucose / Q000378:metabolism; D001800:Blood Specimen Collection; D002851:Chromatography, High Pressure Liquid; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007297:Inpatients; D009203:Myocardial Infarction / Q000097:blood*; D012044:Regression Analysis
D001786:Blood Glucose; D006442:Glycated Hemoglobin