Original paper
Long-term prognostic value of admission hemoglobin A_1c (HbA_1c) level in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Introduction: Many studies have reported the diagnostic and prognostic value of haemoglobin A_1c (HbA_1c) levels in patients with acute coronary syndrome. However, the short- and long-term prognostic value of HbA_1c level in patients with ST elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is controversial.

Aim: To investigate whether admission HbA_1c level has a prognostic value for in-hospital, short-, and long-term cardiovascular (CV) mortality and major adverse cardiovascular events in patients with STEMI undergoing primary PCI.

Material and methods: This prospective study included 443 consecutive patients with STEMI who underwent primary PCI between September 2010 and July 2012. The patients were divided into three groups based on admission HbA_1c levels: group I  (HbA_1c ≤ 5.6%), group II (HbA_1c 5.7–6.4%), and group III (HbA_1c ≥ 6.5%). The in-hospital, 1-month, and 1-year CV events of all 3 patient groups were followed up.

Results: A significant association was found between HbA_1c level and 1-year primary clinical outcomes, including CV mortality, non-fatal reinfarction, and stroke (p = 0.037). In addition, age, Killip class > 1, and left ventricular ejection fraction were found to be independent predictors of long-term CV mortality in multivariate analysis (hazard ratios (95% confidence interval) 1.081 (1.020–1.146), 4.182 (1.171–14.935), and 0.832 (0.752–0.920); p = 0.009, p = 0.028, and p < 0.001, respectively).

Conclusions: In this study, we demonstrated that increased admission HbA_1c levels were associated with higher rates of major adverse CV events, including mortality, non-fatal reinfarction, and stroke, in patients with STEMI who underwent primary PCI.