title: HbA1c Levels and Long-Term Mortality in Patients Undergoing Coronary Angiography.
abstract: OBJECTIVE
  Previous studies investigating the prognostic value of HbA1c in patients undergoing coronary angiography reported a mixed pattern of results. Therefore, we aimed to better define the prognostic power of HbA1c among coronary catheterized patients.
  
  
  METHODS
  Patients undergoing coronary angiography (n = 3,749) were divided into four groups according to HbA1c levels (<5, 5-6, 6-7 and >7%). Cox regression models assessed long-term mortality after adjusting for multiple covariates.
  
  
  RESULTS
  Baseline clinical profiles differed in HbA1c groups, with a higher prevalence of comorbidities in the groups with higher HbA1c levels. Median follow-up was 1,745 days (interquartile range 1,007-2,171). A J-shaped association curve was observed between HbA1c levels and all-cause mortality rates, with patients in the lowest and highest HbA1c groups suffering from significantly higher mortality rates compared to in-between groups (hazard ratio 1.9, 95% CI 1.32-2.74, p = 0.001, and hazard ratio 1.58, 95% CI 1.29-1.95, p < 0.001, for the lowest and highest HbA1c groups, respectively). This association persisted after adjustment for anemia, nutritional status, renal function, cardiovascular risk factors and inflammatory biomarkers.
  
  
  CONCLUSIONS
  HbA1c levels <5 or >7% are predictors of all-cause mortality in patients undergoing coronary angiography.
authors.affiliation: Department of Cardiology, Cardiovascular Research Center, Tel Aviv Medical Center, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Havakuk
authors.forename: Shmuel
authors.initials: S
authors.lastname: Banai
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.forename: Maayan
authors.initials: M
authors.lastname: Konigstein
authors.forename: Eyal
authors.initials: E
authors.lastname: Ben Assa
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.forename: Tomer
authors.initials: T
authors.lastname: Ziv-Baran
authors.forename: Meital
authors.initials: M
authors.lastname: Elbaz
authors.forename: Miri
authors.initials: M
authors.lastname: Revivo
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Ariel
authors.initials: A
authors.lastname: Finkelstein
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin