Higher glycated haemoglobin (HbA1c) is a potential indicator for in-hospital death in acute coronary syndrome (ACS) patients as well as a predictor for short-term mortality in ACS patients, according to a systematic review and meta-analysis.

Researchers from China conducted the review to assess the effect of HbA1c on in-hospital and short-term mortality in ACS patients. This is because HbA1c, the most commonly used indicator of chronic glucose metabolism, is closely associated with cardiovascular disease.

A total of 25 studies involving 304,253 ACS patients were included in the systematic review. The pooled relative risk (RR) of in-hospital mortality was 1.246 (95% confidence interval [CI], 1.113–1.396; p=0.000; I2=48.6%; n=14) after sensitivity analysis in studies reporting HbA1c as categorical valuable. The pooled RR was 1.042 (95% CI, 0.904–1.202; p=0.57; I2=82.7%; n=4) in random-effects model for studies reporting it as continuous variable.

Subgroup analysis by diabetic status showed that elevated HbA1c is associated with increased short-term mortality in ACS patients without diabetes mellitus (DM) history and without DM (RR, 2.31; 95% CI, 1.81–2.94; p=0.000; I2=0.0%; n=5; RR, 2.56; 95% CI, 1.38–4.74; p=0.003; I2=0.0%; n=2, respectively), which was not the case for patients with DM and patients from studies incorporating DM and non-DM individuals (RR, 1.16; 95% CI, 0.79–1.69; p=0.451; I2=31.9%; n=3; and RR, 1.10; 95% CI, 0.51–2.38; p=0.809; I2=47.4%; n=4, respectively).

Reference:
Pan W, et al. Prognostic value of HbA1c for in-hospital and short-term mortality in patients with acute coronary syndrome: a systematic review and meta-analysis. Cardiovasc Diabetol 2019;18:169.