OBJECTIVE To investigate the association between baseline hemoglobin A1c(HbA1c)levels and bleeding in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)who underwent percutaneous coronary interve...OBJECTIVE To investigate the association between baseline hemoglobin A1c(HbA1c)levels and bleeding in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)who underwent percutaneous coronary intervention(PCI).METHODS This observational cohort study enrolled 6283 consecutive NSTE-ACS patients undergoing PCI from January 1,2010 to December 31,2014.Based on baseline HbA1c levels,the patients were divided into the group with HbA1c<7%(n=4740)and the group with HbA1c≥7%(n=1543).The primary outcomes are major bleeding(BARC grades 3-5)and all-cause death during follow-up.RESULTS Of patients enrolled,4705(74.9%)were male,and 2143(34.1%)had a history of diabetes mellitus,with a mean(SD)age of 64.13(10.32)years.The median follow-up duration was 3.21 years.Compared with the patients with HbA1c<7%,the risk of major bleeding events during follow-up was higher in patients with HbA1c≥7%(adjusted hazard ratio[HR]=1.57;95%con-fidence interval[CI]:1.01-2.44;P=0.044),while the risk of all-cause death during follow-up was not associated with the higher HbA1c levels(adjusted HR=0.88;95%CI:0.66-1.18;P=0.398).CONCLUSIONS Compared with the lower baseline HbA1c levels,the higher baseline HbA1c levels were associated with an increase in long-term bleeding risk in NSTE-ACS patients undergoing PCI,though higher baseline HbA1c levels were not associ-ated with the higher risk in all-cause death.展开更多
基金supported by Outstanding Young Medical Talents in Guangdong Province (KJ0120-19456)the Outstanding Young Talent Program of Guangdong Provincial People’s Hospital (Grant No.KJ012019084 and KJ012019095)+2 种基金the High-level Hospital Construction Project (Grant No. DFJH20200-21)Guangdong Provincial People’s Hospital Clinical Research Fund (Y012018085)National Natural Science Foundation of Guangdong Province (KC-022021005)
文摘OBJECTIVE To investigate the association between baseline hemoglobin A1c(HbA1c)levels and bleeding in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)who underwent percutaneous coronary intervention(PCI).METHODS This observational cohort study enrolled 6283 consecutive NSTE-ACS patients undergoing PCI from January 1,2010 to December 31,2014.Based on baseline HbA1c levels,the patients were divided into the group with HbA1c<7%(n=4740)and the group with HbA1c≥7%(n=1543).The primary outcomes are major bleeding(BARC grades 3-5)and all-cause death during follow-up.RESULTS Of patients enrolled,4705(74.9%)were male,and 2143(34.1%)had a history of diabetes mellitus,with a mean(SD)age of 64.13(10.32)years.The median follow-up duration was 3.21 years.Compared with the patients with HbA1c<7%,the risk of major bleeding events during follow-up was higher in patients with HbA1c≥7%(adjusted hazard ratio[HR]=1.57;95%con-fidence interval[CI]:1.01-2.44;P=0.044),while the risk of all-cause death during follow-up was not associated with the higher HbA1c levels(adjusted HR=0.88;95%CI:0.66-1.18;P=0.398).CONCLUSIONS Compared with the lower baseline HbA1c levels,the higher baseline HbA1c levels were associated with an increase in long-term bleeding risk in NSTE-ACS patients undergoing PCI,though higher baseline HbA1c levels were not associ-ated with the higher risk in all-cause death.
