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Article

Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus

1
Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
2
Department of Emergency Medicine, Soroka University Medical Center, Beer Sheva 84101, Israel
3
Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
4
Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
*
Author to whom correspondence should be addressed.
Academic Editor: Toshiaki Nakajima
J. Clin. Med. 2021, 10(15), 3232; https://doi.org/10.3390/jcm10153232
Received: 17 June 2021 / Revised: 15 July 2021 / Accepted: 19 July 2021 / Published: 22 July 2021
Frequent fluctuations of hemoglobin A1c (HbA1C) values predict patient outcomes. However, data regarding prognoses depending on the long-term changes in HbA1C among patients after acute myocardial infarction (AMI) are scarce. We evaluated the prognostic significance of HbA1C levels and changes among diabetic patients (n = 4066) after non-fatal AMI. All the results of HbA1C tests up to the 10-year follow-up were obtained. The changes (∆) of HbA1C were calculated in each patient. The time intervals of ∆HbA1C values were classified as rapid (<one year) and slow (≥one year) changes. The outcome was all-cause mortality. The highest mortality rates of 53.8% and 35.5% were found in the HbA1C < 5.5–7% and ∆HbA1C = −2.5–(−2%) categories. A U-shaped association was observed between HbA1C and mortality: adjOR = 1.887 and adjOR = 1.302 for HbA1C < 5.5% and ≥8.0%, respectively, as compared with 5.5–6.5% (p < 0.001). Additionally, ∆HbA1C was associated with the outcome (U-shaped): adjOR = 2.376 and adjOR = 1.340 for the groups of <−2.5% and ≥2.5% ∆HbA1C, respectively, as compared to minimal ∆HbA1C (±0.5%) (p < 0.001). A rapid increase in HbA1C (but not decrease) was associated with a greater risk of mortality. HbA1C values and their changes are significant prognostic markers for long-term mortality among AMI-DM patients. ∆HbA1C and its timing, in addition to absolute HbA1C values, should be monitored. View Full-Text
Keywords: diabetes mellitus; acute myocardial infarction; hemoglobin A1c; prognosis; mortality diabetes mellitus; acute myocardial infarction; hemoglobin A1c; prognosis; mortality
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MDPI and ACS Style

Plakht, Y.; Gilutz, H.; Shiyovich, A. Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus. J. Clin. Med. 2021, 10, 3232. https://doi.org/10.3390/jcm10153232

AMA Style

Plakht Y, Gilutz H, Shiyovich A. Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus. Journal of Clinical Medicine. 2021; 10(15):3232. https://doi.org/10.3390/jcm10153232

Chicago/Turabian Style

Plakht, Ygal, Harel Gilutz, and Arthur Shiyovich. 2021. "Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus" Journal of Clinical Medicine 10, no. 15: 3232. https://doi.org/10.3390/jcm10153232

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