Glycosylated Hemoglobin and Outcomes in Diabetic Patients with Acute Myocardial Infarction after Successful Revascularization with Stent Placement: Findings from the Guthrie Health Off-Label Stent (GHOST) Investigators

Journal of Interventional Cardiology, 05/04/2012

Singla A et al. – Glycemic control, determined by glycosylated hemoglobin (HbA1c), does not seem to influence cardiovascular outcomes in diabetic patients with acute myocardial infarction (AMI) after successful stent placement.

Methods

  • The authors examined 231 consecutive diabetes mellitus (DM) patients with AMI who underwent successful primary PCI and had evaluation of glycosylated hemoglobin (HbA1c) from 30 days before to 90 days after AMI.
  • Patients were categorized in 2 groups, controlled DM with HbA1c ≤ 7.0 (N = 83, 36%) and uncontrolled DM with HbA1c > 7.0 (N = 148, 64%).
  • They assessed 12–month cardiovascular outcomes in study groups.

Results

  • Uncontrolled diabetics were younger, tended to be less hypertensive, and had higher baseline glomerular filtration rate and final vessel diameter compared to controlled diabetics.
  • Uncontrolled DM patients had similar major adverse cardiovascular events (MACE; composite of all–cause death, MI, target vessel revascularization [TVR], and stent thrombosis [ST]; 20% vs. 30%, log–rank P = 0.54), death (8.8% vs. 12%, P = 0.40), MI (8.8% vs. 9.6%, P = 0.76), TVR (9.5% vs. 8.4%, P = 0.95), and ST (3.4% vs. 4.8%, P = 0.54) as the controlled diabetics.
  • In Cox regression analysis, after adjustment for baseline differences, glycemic control had no independent influence on study outcomes.

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