Effect of glycated hemoglobin on heart function of the patients with revascularization of coronary artery.
BACKGROUND
Patients with diabetes after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) treatment for coronary artery disease (CAD) had higher mortality rates than those without diabetes. There were limited data comparing the cardiac and metabolic differences between diabetes and non-diabetes for CABG and PCI and about impact of pre-procedure GHb level on systolic heart function in patients with diabetes.


OBJECTIVE
To explore the cardio-metabolic differences and to evaluate their potential as significant risk factors.


METHODS
124 patients with diabetes and 170 patients without diabetes were enrolled. Coronary lesions (≥ 70% stenosis in at least one major coronary artery) were documented by angiography. Patients with diabetes were divided into different groups by GHb, Coronary lesions (≥ 70% stenosis in at least one major coronary artery) were documented by angiography. CABG and PCI were performed for all the patients. Cardio-metabolic risk factors before revascularization were compared between them.


RESULTS
Diabetics with GHb ≥ 8% had lower cardiac ejection fraction (EF) values than those with GHb<8% (P<0.05) or patients without diabetes (P<0.05). And count of vascular lesions between the groups was not statistically significant. Observed EF as a dependent variable negatively correlated to GHb levels (P<0.05). The levels of glycated hemoglobin A1c (GHbA1c) rose with increased fasted blood glucose (FBG) values (P<0.001). Even with treatment for hyperglycemia and dyslipidemia, overall levels of fasting blood sugar (FBG, P<0.001), GHbA1c (P<0.001), and triglycerides (TG, P<0.05) in patients with diabetes were still higher than those without diabetes respectively.


CONCLUSIONS
Poorer glucose control with GHb ≥ 8% and decreased systolic heart function are significant risk factors that potentially contribute to worse prognosis for CABG or PCI treatment. Elevated levels of FBG, GHbA1c, and TG are evident for patients with diabetes compared to patients without diabetes prior to revascularization.
Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China.
X Q
XQ
Sun
Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China.
B N
BN
Bao
Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China.
X Y
XY
Gao
Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China ; Beijing Institute of Heart, Lung, and Blood Vessel Diseases Beijing, China.
D E
DE
Yan
Department of Endocrinology & Metabolism, Beijing Anzhen Hospital Affiliated to Capital Medical University Beijing, China ; Beijing Institute of Heart, Lung, and Blood Vessel Diseases Beijing, China.
Y S
YS
Zhou
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D013599:Systole; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D016277:Ventricular Function, Left
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D014280:Triglycerides; C517652:hemoglobin A1c protein, human
EF; GHbA1c; revascularization