scholarly journals Impact of Admission Glycosylated Hemoglobin A1c on Angiographic Characteristics and Short Term Clinical Outcomes of Nondiabetic Patients with Acute ST-Segment Elevation Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Islam El-sherbiny ◽  
Baher Nabil ◽  
Tamer Saber ◽  
Fathy Elsayed Abdelgawad
Keyword(s):  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
University Hospital ◽  
Complete Revascularization ◽  
Cardiac Events ◽  
Short Term ◽  
Acute Stemi ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
Hba1c Levels

We aimed to assess the predictive value of admission HbA1c level in nondiabetic patients presented by acute STEMI, on outcome of PCI and short term outcome of adverse cardiac events.Methods. 60 nondiabetic patients were admitted to Cardiology Department, Zagazig University Hospital, with acute STMI: 27 patients with HbA1c levels of 4.5% to 6.4% (group 1), 17 patients with HbA1c levels of 6.5% to 8.5% (group 2), and 16 patients with HbA1c levels higher than 8.5% (group 3). Either invasive intervention was done at admission by (pPCI) or coronary angiography was done within month (3–28 days) from taking thrombolytic. Participants were followed up for 6 months.Results. There was significant difference among different groups of HbA1c as regards the number of diseased vessels, severity of CAD lesions (pvalue < 0.01), and TIMI flow grades (pvalue < 0.05). There was significant difference among different groups as regards the adverse cardiac events on short term follow-up period (pvalue < 0.05).Conclusion. The present study showed that admission higher HbA1c level in patients presented by acute STEMI is associated with more severe CAD, lower rate of complete revascularization, and higher incidence of adverse cardiac events.

scholarly journals Management and outcomes of significant non-culprit coronary artery lesions in STEMI: a retrospective cohort study

2015 ◽  
Vol 3 ◽  
pp. 14 ◽  
Author(s):  
Robert Erich Michael Weitemeyer ◽  
Shane Peter Murphy ◽  
Ruth Gillen ◽  
Catriona Ahern ◽  
Yousif Abusalma ◽  
...  
Keyword(s):  
Medical Management ◽  
University Hospital ◽  
Cardiac Events ◽  
Index Procedure ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
St Elevation ◽  
Percutaneous Revascularization ◽  
The University

<p>BACKGROUND<br /> In the setting of ST-elevation myocardial infarction (STEMI) and multi-vessel disease (MVD), guidelines recommend revascularization of the culprit lesion (CL) only, due to poor evidence supporting intervention in non-culprit lesions (non-CLs) during the same index procedure. Debate over management for significant non-CLs is of interest i.e. medical management vs. percutaneous revascularization. We describe a cohort of patients with STEMI and MVD and compare the occurrence of major adverse cardiac events (MACE) by therapeutic strategies for non-CLs with regard to follow-up outcomes.</p><p>METHODS<br /> 86 patients with STEMI and MVD were identified from a database of STEMI presentations to the University Hospital Limerick from Jan 2011 to April 2013. The occurrence of MACE was established by follow up with patients’ general practitioners.</p><p>RESULTS<br /> 48% of presentations had MVD. Predominant management for non-CLs was medical therapy alone comprising 58% (n=50) of patients, while 23% (n=20) of patients underwent PCI for non-CL, and 19% (n=16) had CABG.</p><p>Median follow up was 1.8 years (range 9–36 months).  We found no significant difference in the occurrence of MACE  between medical management of non-CLs and PCI of non-CLs (OR 1.10 95%CI 0.34, 3.56; p= 0.88). CABG however does show a trend to be superior to both PCI (OR 3.10 95%CI 0.54, 17.88; p= 0.21) and medical management (OR 2.83 95%CI 0.65, 12.27; P= 0.17) in non-CLs.</p><p>CONCLUSIONS<br /> CABG appears superior to both PCI or medical management in preventing MACE over time, and PCI is not superior to medical management alone.</p>

scholarly journals HbA1c as a prognostic indicator in prediabetics with acute coronary syndrome

2020 ◽  
Vol 8 (6) ◽  
pp. 2004
Author(s):  
Arathi S. Gadwalkar ◽  
Prabhakar K. ◽  
Raveesha A. ◽  
Shaama Ghungroo
Keyword(s):  
Acute Coronary Syndrome ◽  
Prognostic Indicator ◽  
Major Adverse Cardiac Events ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
Significant Difference ◽  
Group 2 ◽  
Hba1c Levels

Background: The role of HbA1C in predicting the outcomes of acute coronary syndrome remains controversial. Lesser is known about it in non-diabetic patients. Therefore authors conducted a study to seek association between the HbA1C levels and the clinical outcome in non-diabetic patients who presented with acute coronary syndrome. Objective of the study was to estimate HbA1C levels in population of prediabetics and non-diabetics and to document and correlate major adverse cardiac events in prediabetic and non-diabetics.Method: This case control study included consecutive patients (n=68) without known diabetes mellitus admitted with acute coronary syndrome (STEMI, NSTEMI, UA) at our hospital. HbA1c was measured on admission. The patients were divided into 2 groups according to their HbA1c level (group 1 HbA1c<5.7%, group 2 HbA1c>5.7%). The main outcome was MACE (major adverse cardiac events including cardiogenic shock, arrhythmia, heart failure).Results: There was no significant difference between baseline characteristics of both groups but complications were seen in higher number cases with HbA1c >5.7%. No significant difference in mortality was found. On analysis HbA1c >5.7% was found to be an independent predictor of MACE.Conclusion: HbA1C is a predictor of major adverse cardiac events. Measurement of HbA1C levels may improve risk assessment in such patients presenting with ACS.

scholarly journals Prognostic Value of Systemic Immune-Inflammation Index for Major Adverse Cardiac Events and Mortality in Severe Aortic Stenosis Patients after TAVI

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 588
Author(s):  
Aydin Rodi Tosu ◽  
Muhsin Kalyoncuoglu ◽  
Halil İbrahim Biter ◽  
Sinem Cakal ◽  
Murat Selcuk ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Prognostic Value ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
Auc Value ◽  
Immune Inflammation

Background and objectives: In this study, we aimed to evaluate whether the systemic immune-inflammation index (SII) has a prognostic value for major adverse cardiac events (MACEs), including stroke, re-hospitalization, and short-term all-cause mortality at 6 months, in aortic stenosis (AS) patients who underwent transcatheter aortic valve implantation (TAVI). Materials and Methods: A total of 120 patients who underwent TAVI due to severe AS were retrospectively included in our study. The main outcome of the study was MACEs and short-term all-cause mortality at 6 months. Results: The SII was found to be higher in TAVI patients who developed MACEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the SII (HR: 1.002, 95%CI: 1.001–1.003, p < 0.01) was an independent predictor of MACEs in AS patients after TAVI. The optimal value of the SII for MACEs in AS patients following TAVI was >1.056 with 94% sensitivity and 96% specificity (AUC (the area under the curve): 0.960, p < 0.01). We noted that the AUC value of SII in predicting MACEs was significantly higher than the AUC value of the C-reactive protein (AUC: 0.960 vs. AUC: 0.714, respectively). Conclusions: This is the first study to show that high pre-procedural SII may have a predictive value for MACEs and short-term mortality in AS patients undergoing TAVI.

Association of Stress hyperglycemia and adverse cardiac events in acute myocardial infarction – A cohort study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annu Rajpurohit ◽  
Bharat Sejoo ◽  
Rajendra Bhati ◽  
Prakash Keswani ◽  
Shrikant Sharma ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Blood Glucose ◽  
Clinical Outcomes ◽  
P Value ◽  
Cardiac Events ◽  
Stress Hyperglycemia ◽  
Adverse Cardiac Events ◽  
Hba1c Levels

Background: Stress hyperglycemia is a common phenomenon in patients presenting with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia at the time of hospital presentation and adverse cardiac events in myocardial infarction during the course of hospital stay. Methods: Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%). Results: Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value = 0.609 and mortality 16.7% vs. 17.3%, p value = 0.856). Conclusions: Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be vigilant for admission blood glucose while treating MI patients.

scholarly journals Effects of Sitagliptin on HbA1c levels in uncontrolled hyperglycemia in diabetics using conventional OAD’s.

2020 ◽  
Vol 27 (05) ◽  
pp. 963-967
Author(s):  
Amar Nazir ◽  
Fida Muhammad Sheikh ◽  
Sheraz Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
Type Ii Diabetes Mellitus ◽  
Cross Sectional ◽  
Entire Study ◽  
Dipeptidyl Peptidase 4 ◽  
Diagnostic Center ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Hba1c Levels

Objectives: The study anticipates to appraise HbA1c levels after three months of sitagliptin addition (100mg/day) to patients already using conventional oral antidiabetics in patients of type II diabetes mellitus who have a meager retort to these existing anti diabetics. Study Design: Mainly cross sectional prospective multicenter, open labeled study. Setting: Department of Medicine University medical diagnostic center & District Head Quarter Hospital Sargodha. Period: January 2017 to June 2017. Material & Methods: 100 inadequately controlled diabetics using different types of oral anti diabetics were chosen and an especially designed performa was accomplished. In our study we gave preference to those patients who were on preexisting oral anti diabetics and now dipeptidyl peptidase 4 inhibitors were added for the first time. The patients were instructed (at the baseline visit) to report during the subsequent visit about glycemic control. Patients were not clued-up that glycosylated hemoglobin control was the main seek of the study, so there was no chance for Pygmalion effect. Results: Levels of glycosylated hemoglobin were significantly reduced after three months of treatment compared to baseline, with a mean alteration in HbA1c level from baseline of −0.77% (range, −0.68 to − -0.86%) in the entire study population at three months. The percentage of patients who achieved an HbA1c level of <6.9% significantly increased after three months of treatment, reaching 58.1%. Conclusion: HbA1c significantly lowered in patients with type 2 diabetes mellitus on conventional OADs after adding sitagliptin.

scholarly journals Influence of Maternal Glycemic Status (HbA1c) at Delivery and Risk of Hypoglycemia in Infants of Diabetic Mothers

2012 ◽  
Vol 2 (2) ◽  
pp. 84-88
Author(s):  
Mst Nurun Nahar Begum ◽  
M Quamrul Hassan ◽  
Maherun Nessa ◽  
Kishwar Azad
Keyword(s):  
Blood Glucose ◽  
Hba1c Level ◽  
Glycosylated Hemoglobin ◽  
Good Control ◽  
Significant Negative Correlation ◽  
Glycemic Status ◽  
Infants Of Diabetic Mothers ◽  
Significant Difference ◽  
Control Study ◽  
Diabetic Mothers

Objective: To examine the influence of maternal HbA1c level at delivery and risk of hypoglycemia in infants of diabetic mothers. Method: This case-control study was done with sixty neonates born to diabetic mothers in BIRDEM hospital. Out of sixty neonates, 30 neonates who developed hypoglycemia during the first 24 hours of age were considered as cases and another 30 neonates who did not develop hypoglycemia during the first 24 hours were considered as controls. Maternal glycemic status was examined by measurement of Glycosylated hemoglobin (HbA1c) and level of <6 % considered good control. Babies were screened for hypoglycemia at birth, then 4, 6, 8, 12, 18 and 24 hours of life. Blood glucose value of less than 2.6 mmol/l was considered as hypoglycemia. Results: Clinical characteristics of newborns and their mothers of cases and controls did not show any significant difference. In majority of cases (73.3%) hypoglycemia was detected by 6 hours of age. Most of babies were asymptomatic (93.3%). Majority of mothers (76.7%) in controls and 46.7% of were in good glycemic controls (HbA1c <6%). The mean HbA1c level of mothers of cases was significantly higher than that of control mothers (6.02 ± 0.98 vs 5.44 ± 0.78; P = 0.014) and significant negative correlation between maternal HbA1c and blood glucose level of neonates ( r=0.422 p= 0.001). Conclusion: There is an association between maternal HbA1c level and neonatal hypoglycemia in infants of diabetic mothers.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12308 (Birdem Med J 2012; 2(2): 84-88)

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