title: The value of admission HbA(1c) level in diabetic patients with acute coronary syndrome.
abstract: BACKGROUND
  Elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with acute coronary syndrome (ACS). However, the prognostic value of diabetic control (ie, hemoglobin A(1c) levels) in patients with ACS is still undefined.
  
  
  OBJECTIVE
  Hemoglobin A(1c) level may predict short-term outcome in patients with ACS.
  
  
  METHODS
  We conducted a retrospective study with prospective follow-up in 317 diabetic patients with ACS. Patients were stratified into 2 groups based on HbA(1c) level, checked within 8 weeks of the index admission (optimal control group, HbA(1c) ≤7%; suboptimal control group, HbA(1c) >7%). All patients were followed up prospectively for major adverse cardiovascular events (MACE) and mortality for 6 months. Short-term clinical outcomes were also compared between the 2 study groups.
  
  
  RESULTS
  In our cohort, 27.4%, 46.4%, and 26.2% patients had unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction, respectively. In-hospital mortality was similar in both HbA(1c) groups (3.37% vs 2.88%, P = 0.803). Six-month MACE was also similar (26.40% vs 26.47%, P = 0.919). All-cause mortality, cardiovascular mortality, symptom-driven revascularization, rehospitalization for angina, and hospitalization for heart failure were also similar in both groups. The hazard ratios for 6-month MACE and individual endpoints were also similar in both groups.
  
  
  CONCLUSIONS
  This study suggests that HbA(1c) levels before admission are not associated with short-term cardiovascular outcome in diabetic patients subsequently admitted with ACS.
authors: Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
authors: Chi Yuen
authors: CY
authors: Chan
authors: Ruijie
authors: R
authors: Li
authors: Joseph Yat Sun
authors: JY
authors: Chan
authors: Qing
authors: Q
authors: Zhang
authors: Chin Pang
authors: CP
authors: Chan
authors: Ming
authors: M
authors: Dong
authors: Bryan P
authors: BP
authors: Yan
authors: Yat-Yin
authors: YY
authors: Lam
authors: Cheuk-Man
authors: CM
authors: Yu
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D003920:Diabetes Mellitus / Q000097:blood* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006331:Heart Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000150:complications / Q000401:mortality / Q000628:therapy; D010343:Patient Admission; D010359:Patient Readmission; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human