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心肌梗死患者糖化血红蛋白(HbA1c)与高敏C反应蛋白(hs-CRP)的相关性及其六个月死亡率随访

Correlation Between Hemoglobin A1c (HbA1c) and High-Sensitivity C-Reactive Protein (hs-CRP) in Myocardial Infarction Patients and Their Six-Month Mortality Follow-Up.

作者信息

Reddy Keesari Sai Sandeep, Varadaraj Priyadarshini, Nallusamy Gunasekaran, SenthilNathan Subbiah

机构信息

Internal Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Aug 17;16(8):e67070. doi: 10.7759/cureus.67070. eCollection 2024 Aug.

Abstract

Background Acute coronary syndrome (ACS), encompassing unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI), poses significant global health challenges because of its associated high mortality and morbidity rates. Vascular inflammation plays a crucial role in the pathogenesis of atherosclerosis, and it is often assessed using biomarkers such as high-sensitivity C-reactive protein (hs-CRP). Hyperglycemia, common in myocardial infarction patients, is linked to increased complications and mortality, with glycosylated hemoglobin A1c (HbA1c) serving as a key indicator of long-term glycemic control. Objective This study investigates the correlation between hs-CRP and HbA1c levels in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM) and evaluates their impact on six-month mortality outcomes. Methods A prospective observational study was conducted with 80 patients diagnosed with AMI. Data collection included demographic information, medical history, clinical assessments, laboratory investigations (including hs-CRP and HbA1c levels), and imaging studies. Patients received standard treatment and were followed up for six months. Statistical analyses were performed to examine the relationships between hs-CRP, HbA1c, and clinical outcomes. Results Higher HbA1c levels at admission were significantly correlated with elevated hs-CRP levels (p < 0.05). Both biomarkers showed a reduction at six months, correlating with improved glycemic control and reduced inflammation. Each unit increase in HbA1c was associated with a 21% increase in the hazard of mortality, and, similarly, each unit increase in hs-CRP was associated with a 17% increase in the hazard of mortality. The positive correlation between HbA1c and hs-CRP suggests that HbA1c can serve as an independent marker for predicting mortality in this patient population. Conclusion The study demonstrates a significant correlation between hs-CRP and HbA1c levels in patients with AMI and T2DM, with both biomarkers serving as strong predictors of six-month mortality. HbA1c, because of its positive correlation with hs-CRP, could be used as an independent marker for assessing the risk of adverse outcomes in these patients. These findings highlight the importance of managing both glycemic control and inflammation in diabetic patients with ACSs.

摘要

背景 急性冠状动脉综合征(ACS)包括不稳定型心绞痛(UA)、非ST段抬高型心肌梗死(NSTEMI)和ST段抬高型心肌梗死(STEMI),因其相关的高死亡率和发病率,对全球健康构成重大挑战。血管炎症在动脉粥样硬化的发病机制中起关键作用,通常使用高敏C反应蛋白(hs-CRP)等生物标志物进行评估。高血糖在心肌梗死患者中很常见,与并发症增加和死亡率升高有关,糖化血红蛋白A1c(HbA1c)是长期血糖控制的关键指标。目的 本研究调查急性心肌梗死(AMI)合并2型糖尿病(T2DM)患者hs-CRP与HbA1c水平之间的相关性,并评估它们对六个月死亡率结局的影响。方法 对80例诊断为AMI的患者进行了一项前瞻性观察研究。数据收集包括人口统计学信息、病史、临床评估、实验室检查(包括hs-CRP和HbA1c水平)以及影像学检查。患者接受标准治疗并随访六个月。进行统计分析以检查hs-CRP、HbA1c与临床结局之间的关系。结果 入院时较高的HbA1c水平与hs-CRP水平升高显著相关(p<0.05)。两种生物标志物在六个月时均有所降低,这与血糖控制改善和炎症减轻相关。HbA1c每升高一个单位,死亡风险增加21%,同样,hs-CRP每升高一个单位,死亡风险增加17%。HbA1c与hs-CRP之间的正相关表明,HbA1c可作为预测该患者群体死亡率的独立标志物。结论 该研究表明,AMI合并T2DM患者的hs-CRP与HbA1c水平之间存在显著相关性,两种生物标志物均是六个月死亡率的强预测指标。由于HbA1c与hs-CRP呈正相关,它可作为评估这些患者不良结局风险的独立标志物。这些发现突出了在患有ACS的糖尿病患者中管理血糖控制和炎症的重要性。

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