Publication: Association of cardiovascular events with glycosylated haemoglobin in diabetic patients
Date
2008
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: In persons with diabetes, chronic hyperglycemia (assessed by glycosylated hemoglobin level) is related to
the development of microvascular disease; however, the relation of glycosylated hemoglobin (HbA1c) to macrovascular
disease is less clear.
Objective: To study the association of cardiovascular events (CVE) with glycosylated haemoglobin in diabetic
patients.
Design: Case control study
Setting: B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
Materials and methods: Fifty diabetic patients with recent cardiovascular events: myocardial infarction (MI) or stroke
was included in the study. There were 25 patients of myocardial infarction and 25 patients of stroke. Fifty diabetic
patients without cardiovascular events were taken as control.
Results: After adjustment for age, smoking, body mass index, systolic blood pressure and total cholesterol at baseline,
level of HbA1c was statistically signi cant (p = 0.017) among patients with CVE. For MI, level of HbA1c was
statistically signi cant (p = 0.018) while for stroke, level of HbA1c was not signi cant (p = 0.694). Mean blood glucose
also predicted CVE and MI but not stroke in this study (p values = 0.006, 0.006 and 0.670 respectively). Fasting and
postprandial plasma glucose was statistically signi cant in CVE (p values = 0.024 and 0.019 respectively). Urine protein
was statistically signi cant for CVE, MI and stroke (p values = 0.000, 0.032, 0.032 and OR 4.571 (95% CI: 1.963-
10.646), 2.667 (95% CI: 1.043-6.815), 2.667 (95% CI: 1.043-6.815) respectively.
Limitations: Sample size was limited due to time constraint and limited resources. Cases with peripheral artery disease
were not included in the study.
Conclusion: Glycosylated haemoglobin is associated with cardiovascular events and myocardial infarction but not
stroke.
Key words: Glycosylated Haemoglobin, Cardiovascular event, Myocardial infarction, Stroke
Description
Deo RK 1, Karki P2, Sharma SK 3, Acharya P4
1 Consultant, Army Hospital, Kathmandu, 2 Professor, 3 Additional Professor, 4 Assistant Professor, Department of Internal Medicine, B.P Koirala Institute of Health Sciences, Dharan, Nepal