Predictive value of HbAlc level for in-hospital acute coronary syndrome patients with diabetes

ZHOU Xiao-liang; LUO Nian-sang; LI Xue-jian; LIN Yong-qing; ZHANG Yu-lin; NIE Ru-qiong; WANG Jing-feng

摘要：Background Diabetes mellitus (DM) is the major risk factor of coronary artery disease (CAD),and the control status of blood sugar has direct effect on the prognosis of CAD.HbAIc is the important parameter reflecting control status of blood sugar,however,it is unclear about the value of in-hospital HbAlc in patients with acute coronary syndrome (ACS).Methods A retrospective analysis was performed for 236 in-hospital diabetic patients with ACS.Patients were stratified into two groups according to HbAIc level when admission (Well controlled group (HbAlc≤7.0％) and High HbAlc group (HbAlc ＞ 7.0％); major adverse cardiovascular events (MACE) group and Non-MACE group).In-hospital MACE and mortality were set as the observation target.Results 282 patients (112 in Well controlled group and 170 in High HbAIc group) were enrolled,of which 146 (51.77％),63 (23.34％),and 73 (25.89％) patients respectively had unstable angina (UA),non-ST-segment elevation myocardial infarction (NSTEMI),and ST-segment elevation myocardial infarction (STEMI).Inhospital all-cause mortality and in-hospital MACE were both similar in Well controlled group and High HbAle group (6.25％ vs.7.06％ and 15.18％ vs.16.47％,P ＞ 0.05).In MACEs,cardiac death (4.46％ vs.5.29％),recurrent myocardial infarction (2.68％ vs.2.94％),hemorrhage events (5.35％ vs.5.29％),malignant arrhythmia (6.25％ vs.5.29％),cardiac shock (4.46％ vs.4.12％),acute heart failure (8.93％ vs.10.0％),revascularization (4.46％ vs.5.29％) were also all similar in both two groups.In addition,there were no significant difference in HbAlc level between MACE group and Non-MACE group.Single-factor logistic regression analysis showed that HbAlc was not a risk factor for in-hospital MACE (P ＞ 0.05)1.Conclusion The present study suggests that admission HbAlc is not the risk factor of in-hospital MACE in ACS patients with diabetes.[S Chin J Cardiol2012; 13(2):105-110]