| Background: The severity of coronary artery disease (CAD) is directly related to the quality of
glucose control in diabetic patients. Additionally, mortality after an acute coronary syndrome
is higher in patients with diabetes and it correlates to the level of glucose control. However,
the role of higher gluconated hemoglobin in the process of coronary atherosclerosis and
clinical outcome of acute myocardial infarction is unknown.
Objectives: To evaluate the association of HbA1c level and severity of CAD and short-term
outcomes of acute ST-elevation myocardial infarction (STEMI) in nondiabetics.
Methods: A total of 290 nondiabetic patients with STEMI were prospectively enrolled following
their admission. Patients were stratified into 2 groups based on the median percent of HbA1c
(⩽5.8% ‘Low’ and >5.8% ‘High’). The severity of CAD based on the Califf scoring system, inhospital
mortality and morbidities of STEMI were compared between groups. Patients were
followed for 1 year after discharge to assess readmission and mortality rate.
Results: The severity score for CAD was significantly higher in the ‘High’ versus ‘Low’ HbA1c
group (7.7 ± 2.7 and 5.5 ± 2.6, p = 0.001). A total of 15 patients died in both groups during the
follow-up period. While in-hospital mortality was similar between the two groups, 12-month
mortality was significantly higher in the ‘High’ group (7.7% versus 2.7%, p = 0.043). In addition,
the rehospitalization rate within 1 year was 8.8% in the ‘Low’ group, which was significantly
lower than 19.0% in the ‘High’ group (p = 0.016).
Conclusion: Among nondiabetic patients presenting with STEMI, the severity of CAD was
higher in those with HbA1c level >5.8%; 1-year mortality and hospital readmission rates were
also higher in this group of patients. |