No association between hemoglobin A1c and in-hospital mortality in patients with diabetes and acute myocardial infarction
No association between hemoglobin A1c and in-hospital mortality in patients with diabetes and acute myocardial infarction
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DOI：
10.1016/j.ahj.2010.12.004
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发表时间：
2011-04-01
影响因子：
4.8
通讯作者：
Fox, Caroline S.
中科院分区：
文献类型：
--
作者：
Britton, Kathryn A.;Aggarwal, Vikas;Fox, Caroline S.
糖尿病患者急性心肌梗死（AMI）后住院死亡率增加，研究表明低血糖和高血糖的风险更高。我们评估糖尿病患者的血红蛋白A1c（A1C）与AMI之间是否存在J形关系。方法我们使用全国范围内既有糖尿病又有A1C测量的AMI患者样本的数据评估A1C与住院死亡率之间的关系结果当连续评估时，我们在多变量分析中没有观察到A1C和住院死亡率之间存在J形关系的证据（线性检验P= 0.89）。最低（= 9.5%）的患者的粗死亡率分别为4.6%和2.8%，而A1C类别的患者的粗死亡率为3.8%（6.5%至2.8%）。
Background Patients with diabetes have increased in-hospital mortality following acute myocardial infarction (AMI), with studies suggesting higher risk with both hypoglycemia and hyperglycemia. We assessed whether a J-shaped relation exists between hemoglobin A1c (A1C) in patients with diabetes and AMI.Methods We assessed the associations between A1C and in-hospital mortality using data from a nationwide sample of AMI patients who had both prior diabetes and measurement of A1C (N = 15,337).Results When evaluated continuously, we observed no evidence of a J-shaped relation between A1C and in-hospital mortality in multivariable analysis (test for linearity P=.89). Patients with lowest (= 9.5%) had a crude mortality rate of 4.6% and 2.8%, respectively, compared with 3.8% among those in the referent A1C category (6.5% to