Xin Zhao1, Yi Kang2, Xiaozeng Wang1, Xiaoxu Yang3, Guannan Ai1,4, Yifei Liu1,4, Pei Xu1,4, Jiyuan Zhang1,4, Chonghuai Gu5, Yan Zhang6, Yongchen Hao7, Dong Zhao7, Yaling Han8. 1. Department of Cardiology, General Hospital of Northern Theater Command, 110016, Shenyang, Liaoning, China. 2. Department of Heart Center, First Hospital of Tsinghua University, 100016, Beijing, China. 3. Department of Cardiology, The Second Affiliated Hospital of Shenyang Medical College, 110016, Shenyang, Liaoning, China. 4. Jinzhou Medical University, 121001, Jinzhou, Liaoning, China. 5. Department of Cardiology, Anqing Hospital Affiliated to Anhui Medical University, Anqing, Auhui, 246003, China. 6. Department of Cardiology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, 110032, Shenyang, China. 7. Department of Epidemiology, Beijing An zhen Hospital, 100000, Beijing, China. 8. Department of Cardiology, General Hospital of Northern Theater Command, 110016, Shenyang, Liaoning, China. hylzglz@163.com.
Abstract
BACKGROUND: Blood glucose levels are associated with the prognosis of patients with acute coronary syndrome (ACS). Glycated hemoglobin (HbA1c) reflects the average blood glucose level. The purpose of the study was to evaluate HbA1c as a prognostic indicator for ACS. METHODS: In total, 27,337 ACS patients from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project were enrolled in this study and divided into three groups according to HbA1c level: Group I, HbA1c level <5.7%; Group II, HbA1c level 5.7-6.4%; Group III, HbA1c level ≥6.5%. The primary outcome was an in-hospital major adverse cardiovascular event (MACE), such as all-cause death, recurrent myocardial infarction, acute or subacute stent thrombosis, heart failure, cardiogenic shock, or cardiac arrest. Baseline data and effectiveness outcome were compared among patients in the three groups. RESULTS: Group III had the highest MACE incidence (13.4% [Group III] vs. 8.7% [Group I] and 10.5% [Group II], p < 0.001). In the logistic regression, there was a statistically significant difference in HbA1c level between the groups (odds ratio [OR]: 1.110, 95% confidence interval [CI]: 1.008-1.133, p < 0.001). In the receiver operating characteristic curve, the area under the curve for MACE was 0.560 (95% CI: 0.550-0.571, p < 0.001); the cut-off value for the HbA1c level was 6.38%. CONCLUSION: The HbA1c level was associated with the risk of MACEs in ACS patients with or without diabetes. Trial Registration clinicaltrials.gov, NCT02306616. Registered 3 December 2014-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02306616 .
BACKGROUND: Blood glucose levels are associated with the prognosis of patients with acute coronary syndrome (ACS). Glycated hemoglobin (HbA1c) reflects the average blood glucose level. The purpose of the study was to evaluate HbA1c as a prognostic indicator for ACS. METHODS: In total, 27,337 ACS patients from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project were enrolled in this study and divided into three groups according to HbA1c level: Group I, HbA1c level <5.7%; Group II, HbA1c level 5.7-6.4%; Group III, HbA1c level ≥6.5%. The primary outcome was an in-hospital major adverse cardiovascular event (MACE), such as all-cause death, recurrent myocardial infarction, acute or subacute stent thrombosis, heart failure, cardiogenic shock, or cardiac arrest. Baseline data and effectiveness outcome were compared among patients in the three groups. RESULTS: Group III had the highest MACE incidence (13.4% [Group III] vs. 8.7% [Group I] and 10.5% [Group II], p < 0.001). In the logistic regression, there was a statistically significant difference in HbA1c level between the groups (odds ratio [OR]: 1.110, 95% confidence interval [CI]: 1.008-1.133, p < 0.001). In the receiver operating characteristic curve, the area under the curve for MACE was 0.560 (95% CI: 0.550-0.571, p < 0.001); the cut-off value for the HbA1c level was 6.38%. CONCLUSION: The HbA1c level was associated with the risk of MACEs in ACS patients with or without diabetes. Trial Registration clinicaltrials.gov, NCT02306616. Registered 3 December 2014-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02306616 .
Authors: S Rasoul; J P Ottervanger; H J G Bilo; J R Timmer; A W J van 't Hof; J H E Dambrink; L D Dikkeschei; J C A Hoorntje; M J de Boer; F Zijlstra Journal: Neth J Med Date: 2007-03 Impact factor: 1.422