The Role of HbA1C & glycated albumin as predictors of cardiovascular outcome post-myocardial infarction in diabetic patients: A matched case-control study

Atiya A. Inamdar; Humayun Kabir; Junaid Muntahi Kabir

doi:10.53730/ijhs.v9n2.15729

Authors

Atiya A. Inamdar
dratiyainamdar99@yahoo.co.in
Jagannath Gupta Institute of Medical Sciences & Hospital, Kolkata, West Bengal, India
Humayun Kabir Fortune Multi-speciality Hospital, Lalbagh, Mursidabad, West Bengal, India
Junaid Muntahi Kabir Independent Researcher, Kolkata, West Bengal, India

Keywords:

Cardio-vascular diseases, Diabetes Mellitus, Glycated albumin, HbA1C, Myocardial Infarction

Abstract

Background: Diabetes mellitus significantly increases the risk of adverse cardiovascular outcomes following ST-elevation myocardial infarction (STEMI). Glycaemic markers like HbA1C and glycated albumin (GA) may serve as prognostic indicators, but their predictive validity in Indian diabetic populations remains underexplored. Thus, this study was conducted to evaluate the prognostic value of HbA1C and GA in predicting adverse cardiovascular outcomes post-MI in diabetic patients. Methods: A matched case-control study was conducted among 260 type II diabetic STEMI patients in a tertiary care hospital. Cases were those developing post-MI complications; age- and sex-matched controls who did not. Glycaemic markers and clinical risk factors were analyzed using conditional logistic regression and ROC analysis. Results: Raised HbA1C and GA levels were significantly associated with higher odds of post-MI complications (aOR: 5.55 and 10.9, respectively). GA showed superior diagnostic accuracy (AUC: 0.948) and specificity (57.6%) over HbA1C. Conclusion: GA is a promising biomarker for risk stratification in diabetic patients post-MI and may complement HbA1C in clinical practice. Keywords: Cardio-vascular Diseases, Diabetes Mellitus, Glycated albumin, HbA1C, Myocardial Infarction

Downloads

Download data is not yet available.

References

Abbas, A., Raza, A., Ullah, M., Hendi, A. A., Akbar, F., Khan, S. U., ... & Rizg, W. Y. (2023). A comprehensive review: epidemiological strategies, catheterization and biomarkers used as a bioweapon in diagnosis and management of cardio vascular diseases. Current Problems in Cardiology, 48(7), 101661. https://doi.org/10.1016/j.cpcardiol.2023.101661

Cavender, M. A., Steg, P. G., Smith Jr, S. C., Eagle, K., Ohman, E. M., Goto, S., ... & Bhatt, D. L. (2015). Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation, 132(10), 923-931.

Ceriello, A., Ihnat, M. A., & Thorpe, J. E. (2009). The “metabolic memory”: is more than just tight glucose control necessary to prevent diabetic complications?. The Journal of Clinical Endocrinology & Metabolism, 94(2), 410-415.

Deedwania, P., Kosiborod, M., Barrett, E., Ceriello, A., Isley, W., Mazzone, T., & Raskin, P. (2008). Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation, 117(12), 1610-1619.

Forbes, J. M., & Cooper, M. E. (2013). Mechanisms of diabetic complications. Physiological reviews, 93(1), 137-188.

Fox, K. A., Steg, P. G., Eagle, K. A., Goodman, S. G., Anderson, F. A., Granger, C. B., ... & Grace Investigators. (2007). Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. Jama, 297(17), 1892-1900.

Furusyo, N., & Hayashi, J. (2013). Glycated albumin and diabetes mellitus. Biochimica et Biophysica Acta (BBA)-General Subjects, 1830(12), 5509-5514. https://doi.org/10.1016/j.bbagen.2013.05.010

Huang, I., Lim, M. A., & Pranata, R. (2020). Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 395-403. https://doi.org/10.1016/j.dsx.2020.04.018

Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., ... & Widimský, P. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal, 39(2), 119-177.

International Diabetes Federation. (2021). IDF Diabetes Atlas, 10th ed. Brussels, Belgium: International Diabetes Federation.

Jiao, X., Zhang, Q., Peng, P., & Shen, Y. (2023). HbA1c is a predictive factor of severe coronary stenosis and major adverse cardiovascular events in patients with both type 2 diabetes and coronary heart disease. Diabetology & Metabolic Syndrome, 15(1), 50.

Kim, Y., Lee, S. H., Kang, M. K., Kim, T. J., Jeong, H. Y., Lee, E. J., ... & Yoon, B. W. (2021). Glycated albumin, a novel biomarker for short-term functional outcomes in acute ischemic stroke. Brain Sciences, 11(3), 337.

Kobayashi, M., Uematsu, T., Nakamura, G., Kokubun, H., Mizuno, T., Betsunoh, H., & Kamai, T. (2018). The predictive value of glycated hemoglobin and albumin for the clinical course following hospitalization of patients with febrile urinary tract infection. Infection & Chemotherapy, 50(3), 228.

Marfella, R., Sasso, F. C., Cacciapuoti, F., Portoghese, M., Rizzo, M. R., Siniscalchi, M., ... & Paolisso, G. (2012). Tight glycemic control may increase regenerative potential of myocardium during acute infarction. The Journal of Clinical Endocrinology & Metabolism, 97(3), 933-942.

Mengstie, M. A., Chekol Abebe, E., Behaile Teklemariam, A., Tilahun Mulu, A., Agidew, M. M., Teshome Azezew, M., ... & Agegnehu Teshome, A. (2022). Endogenous advanced glycation end products in the pathogenesis of chronic diabetic complications. Frontiers in molecular biosciences, 9, 1002710.

Mohan, V., Deepa, R., Shanthi Rani, S., & Premalatha, G. (2001). Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India: The Chennai Urban Population Study (CUPS No. 5). Journal of the American College of Cardiology, 38(3), 682-687.

Monnier, L., Colette, C., & Owens, D. R. (2008). Glycemic variability: the third component of the dysglycemia in diabetes. Is it important? How to measure it?. Journal of diabetes science and technology, 2(6), 1094-1100.

Prabhakaran, D., Jeemon, P., & Roy, A. (2016). Cardiovascular diseases in India: current epidemiology and future directions. Circulation, 133(16), 1605-1620.

Selvin, E., Rawlings, A. M., Lutsey, P. L., Maruthur, N., Pankow, J. S., Steffes, M., & Coresh, J. (2015). Fructosamine and glycated albumin and the risk of cardiovascular outcomes and death. Circulation, 132(4), 269-277.

Unnikrishnan, R., Anjana, R. M., & Mohan, V. (2014). Diabetes in South Asians: is the phenotype different?. Diabetes, 63(1), 53-56.

Wei, C. C., Shyu, K. G., Cheng, J. J., Lo, H. M., & Chiu, C. Z. (2016). Diabetes and adverse cardiovascular outcomes in patients with acute coronary syndrome-data from Taiwan’s Acute Coronary Syndrome Full Spectrum Data Registry. Acta Cardiologica Sinica, 32(1), 31.

Xavier, D., Pais, P., Devereaux, P. J., Xie, C., Prabhakaran, D., Reddy, K. S., ... & Yusuf, S. (2008). Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. The Lancet, 371(9622), 1435-1442.

Yusuf, S., Reddy, S., Ôunpuu, S., & Anand, S. (2001). Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation, 104(22), 2746-2753.

Zhang, X., Du, Y., Guo, Q., Ma, X., Shi, D., & Zhou, Y. (2024). Prognostic value of serum glycated albumin in acute coronary syndrome patients without standard modifiable cardiovascular risk factors. Diabetology & Metabolic Syndrome, 16(1), 278.