Background and aim: Previous studies investigating the prognostic power of HbA1C in patients undergoing coronary intervention reported a mixed pattern of results.
In order to optimally define the prognostic power of HbA1C among these patients, we prospectively stratified a large cohort of catheterized patients along a range of HbA1C levels with an extended period of follow-up.
Methods and results: The cohort included 3595 patients, with male predominance (73.7%). Mean age was 65.8±10.5 years. All underwent coronary angiography. The cohort was divided into four groups according to HbA1C levels (<5%, 5-6%, 6-7%, >7%). Baseline clinical profile was diverse between HbA1C groups, with higher prevalence of co-morbidities in the higher HbA1C groups. Median follow-up was 1745 days, IQR 1007-2171 days. A U-shaped association curve was observed between HbA1C levels and all-cause mortality rates, with patients in the lowest and highest HbA1C groups suffering from significantly higher mortality rates compared to in-between groups (HR–1.9, CI 1.32-2.74, p=0.001 and HR-1.58, CI 1.29-1.95, p<0.001 for the lowest and highest HbA1C groups respectively). This association persisted after adjustment for anemia and nutritional status, renal function and cardiovascular risk factors and biomarkers.
Conclusion: HbA1C levels were found to be significant predictors of all-cause mortality after a coronary intervention. HbA1c levels display a U-shaped association with all-cause mortality.
