AI Article Synopsis
- A study evaluated how changes in glycated hemoglobin (HbA1c) affect mid-term health outcomes in diabetic patients after an acute myocardial infarction (AMI).
- Among 967 patients, those with a decrease in HbA1c >1% had better clinical outcomes compared to those with increases, showing lower rates of major adverse cardiovascular events (MACE), cardiac death, and rehospitalization.
- However, the findings suggest that while a decrease in HbA1c is beneficial, it did not serve as an independent predictor of improved outcomes over 24 months, emphasizing the need for consistent diabetic control instead.
Article Abstract
Background: The average glycated hemoglobin (HbA1c) may not accurately reflect glycemic control status during the mid-term after acute myocardial infarction (AMI). We aimed to evaluate changes in HbA1c and their effect on mid-term clinical outcomes in patients with diabetes and AMI.
Methods: We enrolled patients with diabetes ( n = 967) who underwent HbA1c measurement in the Korean nationwide registry. These patients were categorized into three groups based on changes in HbA1c from index admission to the 1-year follow-up visit: a decrease in HbA1c > 1%, changes in HbA1c within 1%, and an increase in HbA1c > 1%. Clinical outcomes at 24 months were examined.
Results: The baseline HbA1c levels were 8.55 ± 0.85, 7.00 ± 0.98 and 7.07 ± 1.05 ( P = 0.001) and HbA1c levels after 1 year were 6.62 ± 0.73, 7.05 ± 0.98 and 9.26 ± 1.59 ( P = 0.001) for patients with 3 groups, respectively. Patients with a 1% decrease in HbA1c had significantly lower incidence of major adverse cardiovascular events (MACE), cardiac death, and rehospitalization after 24 months than those with a 1% increase in HbA1c. However, in the Cox regression analysis, a >1% decrease in HbA1c change was not an independent factor for MACE, cardiac death, and rehospitalization.
Conclusions: Our analysis indicates that an HbA1c decrease of >1% within the first 12 months was not an independent prognostic factor until the 24-month mark. Therefore, standard diabetic control is recommended for patients with diabetes and AMI for up to 2 years.
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| http://dx.doi.org/10.1097/MCA.0000000000001369 | DOI Listing |
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