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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Glycosylated hemoglobin is associated with decreased endothelial function, high inflammatory response, and adverse clinical outcome in non-diabetic STEMI patients

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Moura, Filipe A. [1] ; Figueiredo, Valeria N. [1] ; Teles, Bruna S. B. S. [2] ; Barbosa, Meyrianne A. [2] ; Pereira, Lara R. [2] ; Costa, Ana P. R. [2] ; Carvalho, Luiz Sergio F. [1] ; Cintra, Riobaldo M. R. [1] ; Almeida, Osorio L. R. [3] ; Quinaglia e Silva, Jose C. [3] ; Nadruz Junior, Wilson [1] ; Sposito, Andrei C. [1] ; Study, Brasilia Heart
Total Authors: 13
[1] State Univ Campinas Med Sch Unicamp, BR-13084971 Campinas, SP - Brazil
[2] Univ Brasilia, Med Sch UnB, Brasilia, DF - Brazil
[3] Hosp Base Dist Fed, Brasilia, DF - Brazil
Total Affiliations: 3
Document type: Journal article
Source: ATHEROSCLEROSIS; v. 243, n. 1, p. 124-130, NOV 2015.
Web of Science Citations: 11

Objective: Chronic dysglycemia was recently identified as a predictor for adverse outcomes in patients with ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention. Data for non-diabetic patients who underwent thrombolysis is scarce. In this context, we aimed to study the effect of HbA1c on cardiovascular outcome after STEMI. Methods: A prospective cohort of 326 non-diabetic STEMI individuals was used for the analyses. We measured plasma glucose, hemoglobin A(1c) {[}HbA(1c)], lipid profile, C-reactive protein (CRP), and nitrate/nitrite (NOx) upon admission and five days after STEMI (D5). Flow-mediated dilation (FMD) was performed 30 days after STEMI. During clinical follow-up, we assessed patients for incident diabetes (progression to HbA1c >= 6.5%) and major adverse cardiac events (MACE), defined as a composite of fatal and non-fatal MI, sudden cardiac death, and angina requiring hospitalization. Results: Using ROC-curve analysis, a 5.8% HbA1c best predicted MACE with a sensitivity of 75% and specificity of 53% (AUC 0.673, p = 0.001). Patients were categorized as high HbA1c if >= 5.8% and low HbA1c if <5.8%. Compared with patients with low HbA1c, those with high HbA1c presented with 20% higher CRP-D5 (p = 0.009) and 19% higher Delta CRP (p = 0.01), a 32% decrease in Delta NOx (p < 0.001), and 33% lower FMD (p < 0.001). After a median follow-up of 1.9 (1.1-2.8) years, patients with high HbA(1c) had more incident diabetes (HR 2.3 95% CI 1.01-5.2; p = 0.048) and MACE (HR 3.32 95% CI 1.09-10.03; p = 0.03). Conclusion: Non-diabetic STEMI patients with high HbA1c present with decreased endothelial function and increased inflammatory response and long-term risk of MACE. (C) 2015 Elsevier Ireland Ltd. All rights reserved. (AU)

FAPESP's process: 12/18044-1 - Effect of niacin on HDL cholesterol and endothelial function in patients with low HDL cholesterol levels with or without hypertriglyceridaemia
Grantee:Valéria Nasser Figueiredo
Support type: Scholarships in Brazil - Post-Doctorate