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Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty

BACKGROUND: Acute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. The underlying mechanism remains elusive and there is a shortage of serum prediction markers. In this study, we investigate the relation...

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Autores principales: She, Jianqing, Deng, Yangyang, Wu, Yue, Xia, Yulong, Li, Hongbing, Liang, Xiao, Shi, Rui, Yuan, Zuyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549379/
https://www.ncbi.nlm.nih.gov/pubmed/28789650
http://dx.doi.org/10.1186/s12933-017-0578-7
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author She, Jianqing
Deng, Yangyang
Wu, Yue
Xia, Yulong
Li, Hongbing
Liang, Xiao
Shi, Rui
Yuan, Zuyi
author_facet She, Jianqing
Deng, Yangyang
Wu, Yue
Xia, Yulong
Li, Hongbing
Liang, Xiao
Shi, Rui
Yuan, Zuyi
author_sort She, Jianqing
collection PubMed
description BACKGROUND: Acute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. The underlying mechanism remains elusive and there is a shortage of serum prediction markers. In this study, we investigate the relationship between admission HbA(1c) and severity of coronary artery stenosis and subsequent prognosis in AMI patients with or without diabetes. RESEARCH DESIGN AND METHODS: We measured admission HbA(1c), and vessel scores based on the number of diseased coronary vessels with significant stenosis in 628 patients diagnosed with AMI. Simple and multi-regression analysis were performed to investigate the correlation between HbA(1c) and the severity of coronary artery stenosis. Major adverse cardiovascular events (MACE), including new-onset myocardial infarction, acute heart failure and cardiac death, were documented during the follow-up. 272 non-DM participants and 137 DM participants were separated into two groups based on HbA(1c) levels for survival analysis during a 2-year follow up. RESULTS: 448 non-DM patients and 180 DM patients were included in the initial observational analysis. 272 non-DM patients and 137 DM patients were included in the follow-up survival analysis. The admission HbA(1c) level was found to be significantly positively correlated to the number of affected vessels suffering from significant coronary artery stenosis both in DM (R square = 0.012; 95% CI 0.002 to 0.623, P = 0.049) and non DM patients (R square = 0.025; 95% CI 0.009 to 0.289, P = 0.037). Kaplan–Meier survival analysis revealed no significant difference with regard to different HbA(1c) levels either in DM or non-DM patients at the end of follow-up. CONCLUSIONS: In patients with AMI, admission HbA(1c) is an important predictor for the severity of coronary artery stenosis in non-DM and DM patients. Further studies are needed to determine whether longer term follow-up could further identify the prognosis effect of HbA(1c) on MACE.
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spelling pubmed-55493792017-08-11 Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty She, Jianqing Deng, Yangyang Wu, Yue Xia, Yulong Li, Hongbing Liang, Xiao Shi, Rui Yuan, Zuyi Cardiovasc Diabetol Original Investigation BACKGROUND: Acute myocardial infarction (AMI) patients with type 2 diabetes mellitus are known to present with multiple vessel lesions during coronary angiography. The underlying mechanism remains elusive and there is a shortage of serum prediction markers. In this study, we investigate the relationship between admission HbA(1c) and severity of coronary artery stenosis and subsequent prognosis in AMI patients with or without diabetes. RESEARCH DESIGN AND METHODS: We measured admission HbA(1c), and vessel scores based on the number of diseased coronary vessels with significant stenosis in 628 patients diagnosed with AMI. Simple and multi-regression analysis were performed to investigate the correlation between HbA(1c) and the severity of coronary artery stenosis. Major adverse cardiovascular events (MACE), including new-onset myocardial infarction, acute heart failure and cardiac death, were documented during the follow-up. 272 non-DM participants and 137 DM participants were separated into two groups based on HbA(1c) levels for survival analysis during a 2-year follow up. RESULTS: 448 non-DM patients and 180 DM patients were included in the initial observational analysis. 272 non-DM patients and 137 DM patients were included in the follow-up survival analysis. The admission HbA(1c) level was found to be significantly positively correlated to the number of affected vessels suffering from significant coronary artery stenosis both in DM (R square = 0.012; 95% CI 0.002 to 0.623, P = 0.049) and non DM patients (R square = 0.025; 95% CI 0.009 to 0.289, P = 0.037). Kaplan–Meier survival analysis revealed no significant difference with regard to different HbA(1c) levels either in DM or non-DM patients at the end of follow-up. CONCLUSIONS: In patients with AMI, admission HbA(1c) is an important predictor for the severity of coronary artery stenosis in non-DM and DM patients. Further studies are needed to determine whether longer term follow-up could further identify the prognosis effect of HbA(1c) on MACE. BioMed Central 2017-08-08 /pmc/articles/PMC5549379/ /pubmed/28789650 http://dx.doi.org/10.1186/s12933-017-0578-7 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Investigation
She, Jianqing
Deng, Yangyang
Wu, Yue
Xia, Yulong
Li, Hongbing
Liang, Xiao
Shi, Rui
Yuan, Zuyi
Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title_full Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title_fullStr Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title_full_unstemmed Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title_short Hemoglobin A(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
title_sort hemoglobin a(1c) is associated with severity of coronary artery stenosis but not with long term clinical outcomes in diabetic and nondiabetic patients with acute myocardial infarction undergoing primary angioplasty
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549379/
https://www.ncbi.nlm.nih.gov/pubmed/28789650
http://dx.doi.org/10.1186/s12933-017-0578-7
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