Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion

Jinhee Ahn, Taek Jong Hong, Jin Sup Park, Hye Won Lee, Jun Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Kwang Soo Cha, Eunyoung Yun, Myung Ho Jeong, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, Whan Seong, Yang Soo Jang, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Seung-Woon Rha, Jang Ho BaeSeung Jung Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective Recent studies have shown continuous control of diabetes is important for favorable outcomes in patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the clinical influence of postprocedural glycosylated hemoglobin A1c (HbA1c) levels on major adverse cardiac events (MACE) in diabetic patients with STEMI after coronary reperfusion. Patients and methods A total of 303 patients with diabetes and STEMI undergoing a primary percutaneous coronary intervention were enrolled in this study. All eligible patients were divided into the following three groups on the basis of follow-up HbA1c (FU-HbA1c) levels, which were measured at a median of 85 days after the procedure: optimal, FU-HbA1c<7%; suboptimal, 7%≤FUHbA1c< 9%; and poor, FU-HbA1c≥9%. We analyzed the 12-month cumulative MACE, defined as mortality, nonfatal myocardial infarction, and revascularization. In addition, we investigated FU-HbA1c levels as a predictor of MACE. Results The incidence rates of MACE differed significantly between groups (6.4 vs. 13.6 vs. 19.6%; P=0.048). Moreover, the risk was increased in each successive group (hazard ratio: 1.00 vs. 2.19 vs. 3.68; P=0.046). Each 1% increase in the FU-HbA1c level posed a 26.6% relative increased risk of MACE (P=0.031). The optimal cutoff value for FU-HbA1c in predicting MACE was 7.45%. Conclusion This study showed that higher levels of early FU-HbA1c after reperfusion in diabetic patients with STEMI were associated with increased 12-month MACE, suggesting continuous serum glucose level control even after reperfusion is important for a better outcome. FUHbA1c seems to be a useful marker for predicting clinical outcome. Coron Artery Dis 26:555-561

Original languageEnglish
Pages (from-to)555-561
Number of pages7
JournalCoronary Artery Disease
Volume26
Issue number7
DOIs
Publication statusPublished - 2015 Sep 25

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Myocardial Reperfusion
Glycosylated Hemoglobin A
Myocardial Infarction
Reperfusion
Myocardial Revascularization
Percutaneous Coronary Intervention
ST Elevation Myocardial Infarction
Hemoglobins
Arteries
Biomarkers
Glucose
Mortality
Incidence
Serum

Keywords

  • glycosylated
  • hemoglobin
  • myocardial infarction
  • outcome
  • ST-segment elevation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion. / Ahn, Jinhee; Hong, Taek Jong; Park, Jin Sup; Lee, Hye Won; Oh, Jun Hyok; Choi, Jung Hyun; Lee, Han Cheol; Cha, Kwang Soo; Yun, Eunyoung; Jeong, Myung Ho; Chae, Shung Chull; Kim, Young Jo; Hur, Seung Ho; Seong, Whan; Jang, Yang Soo; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Rha, Seung-Woon; Bae, Jang Ho; Park, Seung Jung.

In: Coronary Artery Disease, Vol. 26, No. 7, 25.09.2015, p. 555-561.

Research output: Contribution to journalArticle

Ahn, J, Hong, TJ, Park, JS, Lee, HW, Oh, JH, Choi, JH, Lee, HC, Cha, KS, Yun, E, Jeong, MH, Chae, SC, Kim, YJ, Hur, SH, Seong, W, Jang, YS, Cho, MC, Kim, CJ, Seung, KB, Rha, S-W, Bae, JH & Park, SJ 2015, 'Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion', Coronary Artery Disease, vol. 26, no. 7, pp. 555-561. https://doi.org/10.1097/MCA.0000000000000258
Ahn, Jinhee ; Hong, Taek Jong ; Park, Jin Sup ; Lee, Hye Won ; Oh, Jun Hyok ; Choi, Jung Hyun ; Lee, Han Cheol ; Cha, Kwang Soo ; Yun, Eunyoung ; Jeong, Myung Ho ; Chae, Shung Chull ; Kim, Young Jo ; Hur, Seung Ho ; Seong, Whan ; Jang, Yang Soo ; Cho, Myeong Chan ; Kim, Chong Jin ; Seung, Ki Bae ; Rha, Seung-Woon ; Bae, Jang Ho ; Park, Seung Jung. / Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion. In: Coronary Artery Disease. 2015 ; Vol. 26, No. 7. pp. 555-561.
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abstract = "Objective Recent studies have shown continuous control of diabetes is important for favorable outcomes in patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the clinical influence of postprocedural glycosylated hemoglobin A1c (HbA1c) levels on major adverse cardiac events (MACE) in diabetic patients with STEMI after coronary reperfusion. Patients and methods A total of 303 patients with diabetes and STEMI undergoing a primary percutaneous coronary intervention were enrolled in this study. All eligible patients were divided into the following three groups on the basis of follow-up HbA1c (FU-HbA1c) levels, which were measured at a median of 85 days after the procedure: optimal, FU-HbA1c<7{\%}; suboptimal, 7{\%}≤FUHbA1c< 9{\%}; and poor, FU-HbA1c≥9{\%}. We analyzed the 12-month cumulative MACE, defined as mortality, nonfatal myocardial infarction, and revascularization. In addition, we investigated FU-HbA1c levels as a predictor of MACE. Results The incidence rates of MACE differed significantly between groups (6.4 vs. 13.6 vs. 19.6{\%}; P=0.048). Moreover, the risk was increased in each successive group (hazard ratio: 1.00 vs. 2.19 vs. 3.68; P=0.046). Each 1{\%} increase in the FU-HbA1c level posed a 26.6{\%} relative increased risk of MACE (P=0.031). The optimal cutoff value for FU-HbA1c in predicting MACE was 7.45{\%}. Conclusion This study showed that higher levels of early FU-HbA1c after reperfusion in diabetic patients with STEMI were associated with increased 12-month MACE, suggesting continuous serum glucose level control even after reperfusion is important for a better outcome. FUHbA1c seems to be a useful marker for predicting clinical outcome. Coron Artery Dis 26:555-561",
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author = "Jinhee Ahn and Hong, {Taek Jong} and Park, {Jin Sup} and Lee, {Hye Won} and Oh, {Jun Hyok} and Choi, {Jung Hyun} and Lee, {Han Cheol} and Cha, {Kwang Soo} and Eunyoung Yun and Jeong, {Myung Ho} and Chae, {Shung Chull} and Kim, {Young Jo} and Hur, {Seung Ho} and Whan Seong and Jang, {Yang Soo} and Cho, {Myeong Chan} and Kim, {Chong Jin} and Seung, {Ki Bae} and Seung-Woon Rha and Bae, {Jang Ho} and Park, {Seung Jung}",
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T1 - Clinical influence of early follow-up glycosylated hemoglobin levels on cardiovascular outcomes in diabetic patients with ST-segment elevation myocardial infarction after coronary reperfusion

AU - Ahn, Jinhee

AU - Hong, Taek Jong

AU - Park, Jin Sup

AU - Lee, Hye Won

AU - Oh, Jun Hyok

AU - Choi, Jung Hyun

AU - Lee, Han Cheol

AU - Cha, Kwang Soo

AU - Yun, Eunyoung

AU - Jeong, Myung Ho

AU - Chae, Shung Chull

AU - Kim, Young Jo

AU - Hur, Seung Ho

AU - Seong, Whan

AU - Jang, Yang Soo

AU - Cho, Myeong Chan

AU - Kim, Chong Jin

AU - Seung, Ki Bae

AU - Rha, Seung-Woon

AU - Bae, Jang Ho

AU - Park, Seung Jung

PY - 2015/9/25

Y1 - 2015/9/25

N2 - Objective Recent studies have shown continuous control of diabetes is important for favorable outcomes in patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the clinical influence of postprocedural glycosylated hemoglobin A1c (HbA1c) levels on major adverse cardiac events (MACE) in diabetic patients with STEMI after coronary reperfusion. Patients and methods A total of 303 patients with diabetes and STEMI undergoing a primary percutaneous coronary intervention were enrolled in this study. All eligible patients were divided into the following three groups on the basis of follow-up HbA1c (FU-HbA1c) levels, which were measured at a median of 85 days after the procedure: optimal, FU-HbA1c<7%; suboptimal, 7%≤FUHbA1c< 9%; and poor, FU-HbA1c≥9%. We analyzed the 12-month cumulative MACE, defined as mortality, nonfatal myocardial infarction, and revascularization. In addition, we investigated FU-HbA1c levels as a predictor of MACE. Results The incidence rates of MACE differed significantly between groups (6.4 vs. 13.6 vs. 19.6%; P=0.048). Moreover, the risk was increased in each successive group (hazard ratio: 1.00 vs. 2.19 vs. 3.68; P=0.046). Each 1% increase in the FU-HbA1c level posed a 26.6% relative increased risk of MACE (P=0.031). The optimal cutoff value for FU-HbA1c in predicting MACE was 7.45%. Conclusion This study showed that higher levels of early FU-HbA1c after reperfusion in diabetic patients with STEMI were associated with increased 12-month MACE, suggesting continuous serum glucose level control even after reperfusion is important for a better outcome. FUHbA1c seems to be a useful marker for predicting clinical outcome. Coron Artery Dis 26:555-561

AB - Objective Recent studies have shown continuous control of diabetes is important for favorable outcomes in patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the clinical influence of postprocedural glycosylated hemoglobin A1c (HbA1c) levels on major adverse cardiac events (MACE) in diabetic patients with STEMI after coronary reperfusion. Patients and methods A total of 303 patients with diabetes and STEMI undergoing a primary percutaneous coronary intervention were enrolled in this study. All eligible patients were divided into the following three groups on the basis of follow-up HbA1c (FU-HbA1c) levels, which were measured at a median of 85 days after the procedure: optimal, FU-HbA1c<7%; suboptimal, 7%≤FUHbA1c< 9%; and poor, FU-HbA1c≥9%. We analyzed the 12-month cumulative MACE, defined as mortality, nonfatal myocardial infarction, and revascularization. In addition, we investigated FU-HbA1c levels as a predictor of MACE. Results The incidence rates of MACE differed significantly between groups (6.4 vs. 13.6 vs. 19.6%; P=0.048). Moreover, the risk was increased in each successive group (hazard ratio: 1.00 vs. 2.19 vs. 3.68; P=0.046). Each 1% increase in the FU-HbA1c level posed a 26.6% relative increased risk of MACE (P=0.031). The optimal cutoff value for FU-HbA1c in predicting MACE was 7.45%. Conclusion This study showed that higher levels of early FU-HbA1c after reperfusion in diabetic patients with STEMI were associated with increased 12-month MACE, suggesting continuous serum glucose level control even after reperfusion is important for a better outcome. FUHbA1c seems to be a useful marker for predicting clinical outcome. Coron Artery Dis 26:555-561

KW - glycosylated

KW - hemoglobin

KW - myocardial infarction

KW - outcome

KW - ST-segment elevation

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