The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction.
BACKGROUND
Glycosylated hemoglobin (HbA1c) level on admission is a prognostic factor for mortality in patients with and without diabetes after myocardial infarction. In the present study, the authors examined the relationship between admission HbA1c level and myocardial perfusion abnormalities in patients with acute myocardial infarction.


METHODS
One hundred consecutive patients with acute myocardial infarction who were treated with thrombolytic therapy were included in the present prospective study. Blood glucose and HbA1c levels of all patients were measured within 3 h of admission. Patients were divided into three groups according to HbA1c level: 4.5% to 6.4% (n=25), 6.5% to 8.5% (n=28) and higher than 8.5% (n=47). All patients then underwent exercise thallium-201 imaging and coronary angiography to determine ischemic scores and the number of diseased coronary arteries four weeks after admission.


RESULTS
Seven patients died within the four-week follow-up period. There was a significant relationship between admission HbA1c level and mortality (P=0.009). Furthermore, there was a significant relationship between HbA1c level and total ischemic scores in patients with acute myocardial infarction (r=0.482; P=0.001). Ischemic scores increased as HbA1c levels increased in patients with acute myocardial infarction.


CONCLUSIONS
The results demonstrated that admission plasma glucose and HbA1c levels are prognostic factors associated with mortality after acute myocardial infarction.
Cakmak
Mahmut
M
Department of Cardiology, Siyami Ersek Cardiac and Thoracic Surgery Center, Istanbul, Turkey. cakmakmn@yahoo.com
Cakmak
Nazmiye
N
Cetemen
Sebnem
S
Tanriverdi
Halil
H
Enc
Yavuz
Y
Teskin
Onder
O
Kilic
I Dogu
ID
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin