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Admission glycemic variability correlates with in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndrome undergoing percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. 2018; 19(6): 368-373 | 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 undergoing percutaneous coronary intervention

Gong Su1, Tao Zhang1, Hongxia Yang1, Wenlong Dai1, Lei Tian1, Hong Tao2, Tao Wang3, Shuhua Mi1
1Departments 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

Objective: The aim of this 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 syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI).
Methods: We studied 759 diabetic patients with NSTE-ACS undergoing PCI. AGV was accessed based on the mean amplitude of glycemic excursions (MAGEs) in 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 levels 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 those with low MAGE levels during hospitalization. Multivariable analysis revealed that AGV was significantly associated with incidence of in-hospital outcomes (Odds ratio=2.024, 95% CI 1.105-3.704, p=0.022) but hemoglobin A1c (HbA1c) was not. In the receiver-operating characteristic curve analysis for MAGE and HbA1c in predicting in-hospital outcomes, the area under the curve for MAGE (0.608, p=0.012) was superior to that for HbA1c (0.556, p=0.193).
Conclusion: High AGV levels 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


Gong Su, Tao Zhang, Hongxia Yang, Wenlong Dai, Lei Tian, Hong Tao, Tao Wang, Shuhua Mi. Admission glycemic variability correlates with in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Anatol J Cardiol. 2018; 19(6): 368-373

Corresponding Author: Gong Su, China


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