Abstract

*Dr. Remyasri and Dr. Nithish M.Bhandary

ABSTRACT

Background: Glycosylated hemoglobin (HbA1c) is a marker of long-term glycemic control and elevated HbA1c is associated with an increased risk of cardiovascular diseases in patients with diabetes. Moreover, HbA1c is also associated with all-cause mortality and cardiovascular disease even in the absence of diabetes. Both plasma glucose levels and HbA1c were implicated as predictors of prognosis. Methods: This study was conducted as a prospective study, wherein written informed consent was taken prior to the investigation after detailed information given to the participants regarding the study. Non diabetic patients in the age group 22 to 60years; presenting with Acute Coronary Syndrome or ST Elevation MI was taken for the study. Patients were stratified into four groups based on HbA1c levels as low (/=6.5%). They were subjected to follow up after one year by a telephone and/or clinical interview; and checking medical records in case of another visit to hospital. Pre-specified clinical endpoints were defined as cardiac death; nonfatal MI; revascularization / rehospitalisation due to attack of ACS. Results: Heart failure, non-fatal MI, repeat PTCA/TLT, attack of ACS, cardiac death, and heart failure plus ACS were respectively seen in 15.9%, 4.5%, 15.9%, 22.7%, 15.9% and 6.8% of patients with HbA1c between 5.7-6.4%. The independent CV outcome of our combined variable outcomes of one year were statistically significant for HbA1c with odd‘s ratio=4.36 (95% CI of 2.17 – 8.74, p