Background: Prediabetes (preT2D) is considered a subtle adverse cardiovascular (CV) risk factor after acute myocardial infarction. Glycated hemoglobin (HbA1c) ranges to identify preT2D are different between ADA and WHO guidelines (5.7-6.4 vs. 6.0-6.4%, respectively). Aim: To evaluate the prognostic value of HbA1c different preT2D-ranges and their correlation with demographic, instrumental, and laboratory parameters in STEMI. Methods: A total of 1681 patients (mean age 67 ± 13 years; 1217 males) were enrolled. Admission HbA1c was used to identify patients with no-T2D (<5.7%), HbA1c 5.70-5.99%, and WHO-preT2D with HbA1c 6-6.49%, and T2D (HbA1c >= 6.5). Results: HbA1c 5.7-5.99, WHO-preT2D, and T2D progressively correlated with an increasing number of CV risk factors. However, only T2D, but not preT2D, was significantly associated with adverse prognosis (in-hospital and one-year death). Conclusions: PreT2D is correlated with CV risk factors, but not with adverse prognosis as compared to no-T2D. Nonetheless, routine HbA1c testing in the STEMI population and HbA1c-5.7-5.99 patient inclusion in the preT2D category may help to identify those who may benefit from intervention and lifestyle strategies to early prevent preT2D progression.
The role of prediabetes as a predictive factor for the outcomes in patients with stemi. Which is the right range of glycated hemoglobin to adopt in this setting?
Guiducci L;
2021
Abstract
Background: Prediabetes (preT2D) is considered a subtle adverse cardiovascular (CV) risk factor after acute myocardial infarction. Glycated hemoglobin (HbA1c) ranges to identify preT2D are different between ADA and WHO guidelines (5.7-6.4 vs. 6.0-6.4%, respectively). Aim: To evaluate the prognostic value of HbA1c different preT2D-ranges and their correlation with demographic, instrumental, and laboratory parameters in STEMI. Methods: A total of 1681 patients (mean age 67 ± 13 years; 1217 males) were enrolled. Admission HbA1c was used to identify patients with no-T2D (<5.7%), HbA1c 5.70-5.99%, and WHO-preT2D with HbA1c 6-6.49%, and T2D (HbA1c >= 6.5). Results: HbA1c 5.7-5.99, WHO-preT2D, and T2D progressively correlated with an increasing number of CV risk factors. However, only T2D, but not preT2D, was significantly associated with adverse prognosis (in-hospital and one-year death). Conclusions: PreT2D is correlated with CV risk factors, but not with adverse prognosis as compared to no-T2D. Nonetheless, routine HbA1c testing in the STEMI population and HbA1c-5.7-5.99 patient inclusion in the preT2D category may help to identify those who may benefit from intervention and lifestyle strategies to early prevent preT2D progression.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.