Key result
Higher admission HbA1c in non-diabetic STEMI patients is linked to more severe CAD.
Why the study?
Elevated admission glucose increases mortality in acute myocardial infarction regardless of diabetic status, but the relationship between admission HbA1c and short-term outcomes in non-diabetic patients treated by primary PCI required assessment.
Does admission HbA1c level correlate with short term outcomes and coronary artery disease severity in non-diabetic patients with acute STEMI treated by primary PCI?
Observational (n=100)
No
Does admission HbA1c level correlate with short term outcomes and coronary artery disease severity in non-diabetic patients with acute STEMI treated by primary PCI?
Higher admission HbA1c levels in non-diabetic patients presenting with acute STEMI are associated with more severe coronary artery disease and lower ejection fraction.
Answers are grounded in this paper and cite their sources.
Should not yet guide risk stratification in non-diabetic STEMI; hypothesis-generating and requires prospective validation.
Background: Coronary artery disease is one of the most important causes of death in industrialized countries. Diabetes mellitus is a modifiable risk factor for coronary artery disease. It increases the risk of coronary artery disease by 2 to 4-fold.This increased risk occurs in patients with DM and non-diabetic patients with impaired glucose tolerance (IGT). Moreover, increased admission glucose levels may increase mortality rates in patients with acute myocardial infarction (AMI), regardless of diabetic status. Objective: To assess the relationship between admissions HbA1c level and short term outcomes of acute ST elevation myocardial infarction treated by primary PCI in non-diabetic patients. Material and Methods: This is an observational study was conducted at Coronary care unit & coronary catheterization lab unit of cardiology department in Ain Shams University hospitals in the period from 1-9-2018 till 1-3-2019. Results: 100 patients without prior diagnosis of DM were included in our study population Three categories of patients were created according to HbA1c level: Group 1 (<5.7%): 46 patients (46%); Group 2 (5.7 to 6.4%): 38 patients (38%); Group 3 (>6.5%): 16 patients (16%). Baseline characteristics of the study population are shown in Table 1, the mean age of our sample was 55.06±11.73 years and 96% were males, there was highly statistically significant difference found between the 3 groups regarding SYNTAX score with P-value (0.002) & another highly significant difference in EF between the 3 groups. Conclusion: The present study showed that admission higher HbA1c level in non-diabetic patients presented by acute STEMI is associated with more severe CAD. MACE & thrombus burden were not found in this study to be related to glycated hemoglobin. Introducing measurement of HbA1c in the CCU seems to be a simple method to obtain important information on the expected severity of coronary lesions.
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Youssef Bassily (2020) conducted an observational in Acute ST elevation myocardial infarction (n=100). Admission HbA1c level >6.5% vs. Admission HbA1c level <5.7% was evaluated on SYNTAX score (p=0.002). Higher admission HbA1c levels in non-diabetic patients presenting with acute STEMI were significantly associated with more severe coronary artery disease as indicated by higher SYNTAX scores.
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