糖化ヘモグロビン(HbA1c)と心血管イベント : HIJAMI Registryにおける糖尿病のない急性心筋梗塞退院1,615例の検討

概要

論文の詳細を見る
Objective: To examine the value of glycated haemoglobin (HbA1c) concentration, even in patients without known diabetes, as a predictor of future cardiovascular events in survivors of acute myocardial infarction (AMI). Subjects: Between January 1999 and June 2001, we consecutively registered all patients with AMI treated at 17 participating medical institutions in the HIJAMI registry. In a prospective cohort study on AMI, we evaluated 1,615 patients without known diabetes who survived AMI. Results: Mean starting HbAlc level was 5.3 ± 0.5% and mean follow-up period was 4.1 years. The patients were divided into quartiles according to HbA1c level. Despite an increase of HbAlc levels in the highest group, there were no increases in mortality from all causes, cardiovascular disease, re-infarction and cardiovascular events. Only re-admission for heart failure was significantly associated with HbAlc level and was independent of in-hospital revascularization, blood pressure, history of prior myocardial infarction, and left ventricular ejection fraction. Conclusions: HbAlc is a continuous risk factor for readmission for heart failure. Staying compliant with lower HbA1c levels seems to be very important and preventive efforts need to consider not just those with established diabetes but whether it is possible to reduce the HbA1c levels through behavioural means.
東京女子医科大学の論文