Cargando…
Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group
BACKGROUND: Hemoglobin A1C (HbA1c) is a form of glycated hemoglobin used to estimate glycemic control in diabetic patients. Data regarding the prognostic significance of HbA1c levels in contemporary intensive cardiac care unit (ICCU) patients is limited. METHODS: All patients admitted to the ICCU at...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153197/ https://www.ncbi.nlm.nih.gov/pubmed/35637510 http://dx.doi.org/10.1186/s12933-022-01529-1 |
_version_ | 1784717800243200000 |
---|---|
author | Lupu, Lior Taha, Louay Farkash, Rivka Bayya, Feras Karmi, Mohammad Steinmetz, Yoed Shaheen, Fauzi Fadi Perel, Nimrod Hamayel, Kamal Levi, Nir Maller, Tommer Karameh, Hani Lichewitz, Gavriel Gavish, Dov Algur, Nurit Glikson, Michael Asher, Elad |
author_facet | Lupu, Lior Taha, Louay Farkash, Rivka Bayya, Feras Karmi, Mohammad Steinmetz, Yoed Shaheen, Fauzi Fadi Perel, Nimrod Hamayel, Kamal Levi, Nir Maller, Tommer Karameh, Hani Lichewitz, Gavriel Gavish, Dov Algur, Nurit Glikson, Michael Asher, Elad |
author_sort | Lupu, Lior |
collection | PubMed |
description | BACKGROUND: Hemoglobin A1C (HbA1c) is a form of glycated hemoglobin used to estimate glycemic control in diabetic patients. Data regarding the prognostic significance of HbA1c levels in contemporary intensive cardiac care unit (ICCU) patients is limited. METHODS: All patients admitted to the ICCU at a tertiary care medical center between January 1, 2020, and June 30, 2021, with documented admission HbA1c levels were included in the study. Patients were divided into 3 groups according to their HbA1c levels: < 5.7 g% [no diabetes mellitus (DM)], 5.7–6.4 g% (pre-DM), ≥ 6.5 g% (DM). RESULTS: A total of 1412 patients were included. Of them, 974 (69%) were male with a mean age of 67(± 15.7) years old. HbA1c level < 5.7 g% was found in 550 (39%) patients, 5.7–6.4 g% in 458 (32.4%) patients and ≥ 6.5 g% in 404 (28.6%) patients. Among patients who did not know they had DM, 81 (9.3%) patients had high HbA1c levels (≥ 6.5 g%) on admission. The crude mortality rate at follow-up (up to 1.5 years) was almost twice as high among patients with pre-DM and DM than in patients with no DM (10.6% vs. 5.4%, respectively, p = 0.01). Interestingly, although not statistically significant, the trend was that pre-DM patients had the strongest association with mortality rate [HR 1.83, (95% CI 0.936–3.588); p = 0.077]. CONCLUSIONS: Although an HbA1c level of ≥ 5.7 g% (pre-DM & DM) is associated with a worse prognosis in patients admitted to ICCU, pre-DM patients, paradoxically, have the highest risk for short and long-term mortality rates. |
format | Online Article Text |
id | pubmed-9153197 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-91531972022-06-01 Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group Lupu, Lior Taha, Louay Farkash, Rivka Bayya, Feras Karmi, Mohammad Steinmetz, Yoed Shaheen, Fauzi Fadi Perel, Nimrod Hamayel, Kamal Levi, Nir Maller, Tommer Karameh, Hani Lichewitz, Gavriel Gavish, Dov Algur, Nurit Glikson, Michael Asher, Elad Cardiovasc Diabetol Research BACKGROUND: Hemoglobin A1C (HbA1c) is a form of glycated hemoglobin used to estimate glycemic control in diabetic patients. Data regarding the prognostic significance of HbA1c levels in contemporary intensive cardiac care unit (ICCU) patients is limited. METHODS: All patients admitted to the ICCU at a tertiary care medical center between January 1, 2020, and June 30, 2021, with documented admission HbA1c levels were included in the study. Patients were divided into 3 groups according to their HbA1c levels: < 5.7 g% [no diabetes mellitus (DM)], 5.7–6.4 g% (pre-DM), ≥ 6.5 g% (DM). RESULTS: A total of 1412 patients were included. Of them, 974 (69%) were male with a mean age of 67(± 15.7) years old. HbA1c level < 5.7 g% was found in 550 (39%) patients, 5.7–6.4 g% in 458 (32.4%) patients and ≥ 6.5 g% in 404 (28.6%) patients. Among patients who did not know they had DM, 81 (9.3%) patients had high HbA1c levels (≥ 6.5 g%) on admission. The crude mortality rate at follow-up (up to 1.5 years) was almost twice as high among patients with pre-DM and DM than in patients with no DM (10.6% vs. 5.4%, respectively, p = 0.01). Interestingly, although not statistically significant, the trend was that pre-DM patients had the strongest association with mortality rate [HR 1.83, (95% CI 0.936–3.588); p = 0.077]. CONCLUSIONS: Although an HbA1c level of ≥ 5.7 g% (pre-DM & DM) is associated with a worse prognosis in patients admitted to ICCU, pre-DM patients, paradoxically, have the highest risk for short and long-term mortality rates. BioMed Central 2022-05-30 /pmc/articles/PMC9153197/ /pubmed/35637510 http://dx.doi.org/10.1186/s12933-022-01529-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lupu, Lior Taha, Louay Farkash, Rivka Bayya, Feras Karmi, Mohammad Steinmetz, Yoed Shaheen, Fauzi Fadi Perel, Nimrod Hamayel, Kamal Levi, Nir Maller, Tommer Karameh, Hani Lichewitz, Gavriel Gavish, Dov Algur, Nurit Glikson, Michael Asher, Elad Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title | Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title_full | Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title_fullStr | Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title_full_unstemmed | Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title_short | Hemoglobin A1C as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: The Jerusalem platelets thrombosis and intervention in cardiology (JUPITER-6) study group |
title_sort | hemoglobin a1c as a prognostic factor and the pre-diabetic paradox in patients admitted to a tertiary care medical center intensive cardiac care unit: the jerusalem platelets thrombosis and intervention in cardiology (jupiter-6) study group |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153197/ https://www.ncbi.nlm.nih.gov/pubmed/35637510 http://dx.doi.org/10.1186/s12933-022-01529-1 |
work_keys_str_mv | AT lupulior hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT tahalouay hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT farkashrivka hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT bayyaferas hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT karmimohammad hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT steinmetzyoed hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT shaheenfauzifadi hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT perelnimrod hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT hamayelkamal hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT levinir hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT mallertommer hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT karamehhani hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT lichewitzgavriel hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT gavishdov hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT algurnurit hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT gliksonmichael hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup AT asherelad hemoglobina1casaprognosticfactorandtheprediabeticparadoxinpatientsadmittedtoatertiarycaremedicalcenterintensivecardiaccareunitthejerusalemplateletsthrombosisandinterventionincardiologyjupiter6studygroup |