The Role of HbA1c in Severity and Mortality Rate of ST Segment Elevation Myocardial Infarction for Hospitalized Libyan Non-Diabetic Patients

Abstract

Background: The severity of coronary artery disease (CAD) is directly related to the quality of glucose control in diabetic patient. Additionally, diabetes is associated with increased mortality following acute myocardial infarction compared to general population. Objectives: To evaluate the association of HbA1c level and severity of CAD, and outcome of non-diabetic patient with STEMI in our hospital. Patients and Methods: 60 consecutives non-diabetic patient with acute ST elevation myocardial infarction were treated with thrombolytic therapy included in the present prospective study. Blood glucose and HbA1c level of all patients were measured within 3 hours of admission. Patient were divided in to 3 groups according to HbA1c level: with cut-off 6.5% as diagnostic criteria of diabetes mellitus according to (American diabetes association) group (1) 6.5%, group (2) 6.5 to 8.5%, group (3) 8.5% and above. In hospital. mortality and morbidities of acute STEMI were compared between groups. Results: The mean age was 63±15 year and mean body mass index was 26. 6±6 kg/m², 24 patients (40%) had history of hypertension, 27 patients (45%) of dyslipidemia, 36 patients (60%) were smoker. We found 45 patients with HbA1c ≤ 6 5%, 5 patients with HbA1c 6.5 -8.5 %, 10 patients with HbA1c ≥ 8.5%. There was strong correlation between admission of HbA1c and admission glucose level (P< 0.001). Infarct size as measured by peak creatinin kinase, was not correlated with HbA1c level. Conclusions: HbA1c is an important risk marker in the absence of history of diabetes mellitus in patients with AMI. The optimal management in these patients may contribute in decrease hospital mortality.