title: Impact of initial glycosylated hemoglobin level on cardiovascular outcomes in prediabetic patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  The prognostic value of the glycemic control level, as measured using glycosylated hemoglobin (HbA1c) level, in prediabetic patients with acute coronary syndrome is still undetermined. The aim of this study was to demonstrate the influence of HbA1c level at admission on the incidence of major adverse cardiac events (MACE) in prediabetic patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Using data from the Korea Working Group on Myocardial Infarction (February 2008-December 2011), this observational study included 2470 STEMI patients undergoing primary PCI who had not been diagnosed with diabetes mellitus either before or after admission (HbA1c at admission <6.5%). Patients were divided into two groups based on HbA1c at admission: prediabetic (5.7% ≤ HbA1c ≤ 6.4%, n=1475, 59.5%) and nondiabetic (HbA1c<5.7%, n=995, 40.5%). After analyzing the matched cohort, 1-year cumulative MACE incidence, defined as a composite of mortality, nonfatal myocardial infarction, repeated PCI, or coronary artery bypass graft, MACE was not found to differ significantly between the two groups (6.7 vs. 6.0%, P=0.616). Using multivariate logistic analysis, HbA1c level at admission was not significantly associated with the occurrence of MACE (odds ratio 0.925, 95% confidence interval 0.618-1.384, P=0.925).
  
  
  CONCLUSIONS
  This study demonstrated that HbA1c level at admission was not significantly associated with cardiovascular outcomes in prediabetic Korean populations with STEMI undergoing primary PCI.
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Donghun
authors.initials: D
authors.lastname: Shin
authors.forename: Jinhee
authors.initials: J
authors.lastname: Ahn
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.forename: Jin Sup
authors.initials: JS
authors.lastname: Park
authors.forename: Jun-Hyok
authors.initials: JH
authors.lastname: Oh
authors.forename: Hye-Won
authors.initials: HW
authors.lastname: Lee
authors.forename: Ju-Yong
authors.initials: JY
authors.lastname: Hong
authors.forename: Bo-Won
authors.initials: BW
authors.lastname: Kim
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology*; D062645:Percutaneous Coronary Intervention; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin