Prognostic significance of the hemoglobin A1c level in non-diabetic patients undergoing percutaneous coronary intervention: a meta-analysis  

作　　者：Yan Li Xiao-Wen Li Yin-Hua Zhang Lei-Min Zhang Qing-Qing Wu Zhao-Run Bai Jin Si Xue-Bing Zuo Ning Shi Jing Li Xi Chu 

机构地区：[1]Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China [2]Department of Emergency,Aerospace Center Hospital,Beijing 100049,China [3]Department of Internal Medicine,Qinghe Substation Hospital of Beijing Municipal Administration of Prisons,Beijing 300481,China [4]Department of Cardiology,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China [5]Health Management Center,Xuanwu Hospital,Capital Medical University,Beijing 100053,China

出　　处：《Chinese Medical Journal》2020年第18期2229-2235,共7页中华医学杂志（英文版）

基　　金：supported by grants from the National Natural Science Foundation of China(No.81872708)and Municipal Key Laboratory of Clinical Epidemiology,Beijing 100069,China.

摘　　要：Background:The predictive value of hemoglobin A1c(HbA1c)levels in non-diabetic patients with myocardial infarction undergoing percutaneous coronary intervention(PCI)is still controversial.This study aimed to evaluate whether HbA1c levels were independently associated with adverse clinical outcomes in non-diabetic patients with coronary artery disease(CAD)who had undergone PCI by performing a meta-analysis of cohort studies.Methods:This meta-analysis included non-diabetic patients with CAD who had undergone PCI.A systematic search for publications listed in the PubMed,Embase,and Cochrane Library databases from commencement to December 2018 was conducted.Studies evaluating the adverse clinical outcomes according to abnormal HbA1c levels in non-diabetic patients diagnosed with CAD who had undergone PCI were eligible.The primary outcomes were long-term all-cause deaths and long-term major adverse cardiac events,and the secondary outcome was short-term all-cause deaths.The meta-analysis was conducted with RevMan 5.3 and Stata software 14.0.Odds ratios(ORs)were pooled using a random or fixed-effects model,depending on the heterogeneity of the included studies.Sub-group analysis or sensitivity analysis was conducted to explore potential sources of heterogeneity,when necessary.Results:Six prospective cohort studies involving 10,721 patients met the inclusion criteria.From the pooled analysis,abnormal HbA1c levels were associated with increased risk for long-term all-cause death(OR 1.39,95%confidence interval[CI]1.16-1.68,P=0.001,I2=45%).Sub-group analysis suggested that abnormal HbA1c levels between 6.0%and 6.5%predicted higher long-term major adverse cardiac event(including all-cause deaths,non-fatal myocardial infarction,target lesion revascularization,target vessel revascularization,recurrent acute myocardial infarction,heart failure requiring hospitalization,and stent thrombosis)risk(OR 2.05,95%CI 1.46-2.87,P<0.001,I2=0).Contrarily,elevated HbA1c levels were not associated with increased risk of short-term all-cause

关 键 词：Acute myocardial infarction Hemoglobin A1c Percutaneous coronary intervention PRE-DIABETES 

分 类 号：R543.3[医药卫生—心血管疾病]