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 branch 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


Keywords


glycated haemoglobin (HbA1c), acute myocardial infarction, diabetes mellitus

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References


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