Shafique Ahmad, Shehzad Ahmad, Mohammad Kashif.
Increasing HbA1C Level; a Prognostic Indicator of Increased Thirty Days Mortality in Patients of ST-Segment Elevation in Myocardial Infarction.
Pak J Med Health Sci Jan ;6(3):724-6.

Objective: To determine the association of glycated hemoglobin with short term mortality after myocardial infarction Study design: Prospective case-control type of study Place and duration: Deptt. of Cardiology, B. V Hospital Bahawalpur from 01-04-2010 to 31-08-2012. Patients and methods: Initially, 955 patients presenting with myocardial infarction (MI) were enrolled in the study. About 201 patients dropped out from study because of early deaths (n=17), falling in the impaired glucose tolerance range on subsequent oral glucose tolerance test (OGTT) (n=67), having dyslipidemia on investigations (n=20) or because of the other co-morbidities like chronic renal failure (n=34), stroke (n=42) or previous history of MI (n=21). The remaining 754 patients were divided into two groups, diabetics and non-diabetics, depending upon the results of oral glucose tolerance test. Glycated hemoglobin HbA1C level was determined in all the patients. These patients were followed up after 30 days and the number of deaths was estimated. Data was analyzed using SPSS version 10. Results: In non-diabetic patients, increasing HbA1C level (>5.5%) resulted in significantly increased number of deaths while in diabetic group, HbA1C level was not significantly associated with increased mortality in one month period after the acute myocardial infarction. Conclusion: Higher levels of HbA1C in diabetic as well as non-diabetic patients increase the risk of short term mortality after acute myocardial infarction.

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