HbA1c–An indicator of adverse outcome in non diabetic patients with acute myocardial infarction

Dr.M.Ashok; Dr.K.Vanitha; Dr.T.Balasubramanian; Dr.R.Freethi

Volume : VII, Issue : X, October - 2018

HbA1c–An indicator of adverse outcome in non diabetic patients with acute myocardial infarction

Dr. M. Ashok, Dr. K. Vanitha, Dr. T. Balasubramanian, Dr. R. Freethi

Abstract :

BACKGROUND

The prevalence of type 2 DM or impaired glucose tolerance by oral glucose tolerance test is about 65% in STEMI patients without history of diabetes. Risk of adverse outcome can be assessed by estimation of admission plasma glucose and glycated haemoglobin (HbA1c) levels. HbA1c level is a reliable biomarker of average blood glucose concentrations and minimally affected by stress hyperglycaemia during AMI.

Aim and objective

To assess whether the HbA1c levels can be used as a prognostic indicator and could be used in identifying risk of adverse outcomes in patients with AMI with unknown diabetes mellitus(DM).

MATERIALS AND METHODS:

This study includes 150 non diabetic patients with AMI admitted into the coronary care unit. HbA1c was measured and Patients were graded into three groups by levels of HbA1c: < 5.5%, 5.5–6.4%, >6.4%.Left ventricular ejection fraction (LVEF) was assessed by echocardiography and Continuous monitoring to determine any type of significant arrhythmia. Association between HbA1c groups and classic cardiovascular risk factor and in–hospital adverse outcomes were assessed by chi–square test and one way anova analysis.

RESULTS

In–hospital mortality was 5.3% (8/150 patients). Higher HbA1c was associated with Killip�s class>1(p .055>0.05), LVEF%.(p .000<0.05), increased heart rate (p .011<0.05), GRACE score(p .017<0.05), bundle anch block14.4%,ventricular tachycardia26.7%,AV block18.9% in group II.

Conclusion

Increased HbA1c levels was a strong and independent predictor of severity of adverse outcome in patients with acute myocardial infarction without known diabetes mellitus