title: Impact of admission glycemia and glycosylated hemoglobin A1c on long-term clinical outcomes of non-diabetic patients with acute coronary syndrome.
abstract: BACKGROUND
  Admission glucose levels have proven to be a predictor in patients with acute myocardial infarction and elevated glycosylated hemoglobin A1c (HbA1c) is associated with an increased risk of cardiovascular disease, even in patients without diabetes. However, the effect of both admission glucose and HbA1c levels on clinical outcomes in non-diabetic patients with acute coronary syndrome (ACS) has not been fully elucidated. We evaluated the combined effect of admission glucose and HbA1c values on long-term clinical outcomes in non-diabetic patients with ACS treated with percutaneous coronary intervention (PCI).
  
  
  RESULTS
  This was an observational study of 452 consecutive non-diabetic patients with ACS who underwent PCI between January 1997 and December 2006. The patients were assigned to four groups according to the median values of admission glucose and HbA1c. The primary endpoint comprising a composite of all-cause death and non-fatal MI was compared among the four groups. The primary endpoint occurred in 13.3% of the participants during a median follow-up period of 4.7 years. The cumulative incidence rate of primary endpoint significantly differed among the groups (p=0.048). Multivariable Cox regression analysis showed that the combination of elevated admission glucose and HbA1c was independently associated with long-term clinical outcomes.
  
  
  CONCLUSIONS
  Combined admission glucose and HbA1c values were independently associated with clinical outcomes in non-diabetic patients with ACS treated with PCI.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan. Electronic address: ktmmy@juntendo.ac.jp.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002423:Cause of Death; D003920:Diabetes Mellitus; D005260:Female; D005544:Forecasting; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Acute coronary syndrome; Glucose; Glycosylated hemoglobin A1c; Non-diabetes