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Admission glycemic variability correlates with in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndrome underwent percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-47487 | DOI: 10.14744/AnatolJCardiol.2018.47487  

Admission glycemic variability correlates with in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndrome underwent percutaneous coronary intervention

Gong Su1, Tao Zhang1, Hongxia Yang1, Wenlong Dai1, Lei Tian1, Hong Tao2, Tao Wang3, Shuhua Mi1
1Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
2Department of Endocrinology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
3Department of Thoracic Surgery, Chinese People’s Liberation Army General Hospital, Beijing, China

Objectives The aim of the study is to evaluate the effects of admission glycemic variability (AGV) on in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).
Methods We studied 759 diabetic patients with NSTE-ACS undergoing PCI. The AGV was accessed by mean amplitude of glycemic excursions (MAGE) of the first 24 hours after admission. Primary outcome was a composite of in-hospital events all-cause mortality, new-onset myocardial infarction, acute heart failure and stroke. Secondary outcomes were each of these considered separately. Predictive effects of AGV on the in-hospital outcomes in patients were analyzed.
Results Patients with high MAGE level had significantly higher incidence of total outcomes (9.9% vs. 4.8%, p=0.009) and all-cause mortality (2.3% vs. 0.4%, P=0.023) than patients with low MAGE level during hospitalization. Multivariable analysis revealed that AGV was significantly associated with incidence of in-hospital outcomes (OR=2.024, 95%CI 1.105-3.704, P=0.022), but hemoglobin A1c (HbA1c) were not. In ROC curve for MAGE and HbA1c in predicting in-hospital outcomes, the area under the receiver-operating characteristic curve for MAGE (0.608, p=0.012) was superior to that for HbA1c (0.556, p = 0.193).
Conclusions High AGV level may be closely correlated with increased in-hospital poor outcomes in diabetic patients with NSTE-ACS following PCI.

Keywords: glycemic variability, diabetes, acute coronary syndrome, risk factor




Corresponding Author: Gong Su, China


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