HbA1c: A Marker for Severity of Acute Myocardial Infarction
Journal Title: International Journal of Interdisciplinary and Multidisciplinary Studies (IJIMS) - Year 2016, Vol 3, Issue 4
Abstract
Hyperglycaemia is independent risk factor for cardiovascular diseases. HbA1c could be considered as a good marker for glycaemic control. Recent reports have found that elevated HbA1c levels are also predictive for cardiovascular disease and mortality. Present study was undertaken to find out the correlation between HbA1c levels and complications and outcome in patients of acute myocardial infarction.Present prospective observational study was conducted on 200 patients admitted to the medical wards in hospital with acute myocardial infarction with or without diabetes mellitus. After a detailed history and physical examination, HbA1c, lipid profile, cardiac enzymes,ECG and echocardiogram were performed in all patients. The patients were then divided into two groups based on the HbA1c levels i.e. good glycaemic control (HbA1c< 7%) and poor glycaemic control (HbA1c>/= 7%).Data was analysed using SPSS software ver. 21 usingappropriate statistical tests. P-value of less than 0.05 was taken as level of significance. Poor glycaemic control was seen in 52.5% patients. No difference was observed between the groupswith respect to gender distribution, duration of hospital stay and patient’s outcome. Past history of MI was found to be significantly associated with poor glycaemic control (53.3% vs 38.9%). On comparing the association of outcome in high risk groups as per glycaemic control, we observed that poor outcome in MI was significantly associated with elderly population (16.9% vs 3.5%; p< 0.05). It was concluded that in patients with age greater than 60 years, the occurrence of higher HbA1c levels is found to be associated with increased incidence of mortality. So, high HbA1c in elderly population should be considered a risk factor for mortality and hence active management should be done to keep HbA1c level strictly below 7 in this population.
Authors and Affiliations
Santosh Gosavi, ShilpaKarande, Kapil Raut
Keywords
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