Relationship between glycosylated hemoglobin assessment and glucose therapy intensification in patients with diabetes hospitalized for acute myocardial infarction

Joshua M. Stolker, John A. Spertus, Darren K McGuire, Marcus Lind, Fengming Tang, Philip G. Jones, Silvio E. Inzucchi, Saif S. Rathore, Thomas M. Maddox, Frederick A. Masoudi, Mikhail Kosiborod

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE - To evaluate the relationship between A1C and glucose therapy intensification (GTI) in patients with diabetesmellitus (DM) hospitalized for acute myocardial infarction (AMI). RESEARCH DESIGN AND METHODS - A1C was measured as part of routine care (clinical A1C) or in the core laboratory (laboratory A1C, results unavailable to clinicians). GTI predictors were identified using hierarchical Poisson regression. RESULTS - Of 1,274 patients, 886 (70%) had clinical A1C and an additional 263 had laboratory A1C measured. Overall, A1C was <7% in 419 (37%), 7-9% in 415 (36%), and <9% in 315 patients (27%). GTI occurred in 31% of patients and was more frequent in those with clinical A1C both before (34 vs. 24%, P < 0.001) and after multivariable adjustment (relative risk 1.34 [95% CI 1.12-1.62] vs. no clinical A1C). CONCLUSIONS - Long-term glucose control is poor in most AMI patients with DM, but only a minority of patients undergo GTI at discharge. Inpatient A1C assessment is strongly associated with intensification of glucose-lowering therapy.

Original languageEnglish (US)
Pages (from-to)991-993
Number of pages3
JournalDiabetes Care
Volume35
Issue number5
DOIs
StatePublished - May 2012

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Glycosylated Hemoglobin A
Myocardial Infarction
Glucose
Therapeutics
Inpatients
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Relationship between glycosylated hemoglobin assessment and glucose therapy intensification in patients with diabetes hospitalized for acute myocardial infarction. / Stolker, Joshua M.; Spertus, John A.; McGuire, Darren K; Lind, Marcus; Tang, Fengming; Jones, Philip G.; Inzucchi, Silvio E.; Rathore, Saif S.; Maddox, Thomas M.; Masoudi, Frederick A.; Kosiborod, Mikhail.

In: Diabetes Care, Vol. 35, No. 5, 05.2012, p. 991-993.

Research output: Contribution to journalArticle

Stolker, JM, Spertus, JA, McGuire, DK, Lind, M, Tang, F, Jones, PG, Inzucchi, SE, Rathore, SS, Maddox, TM, Masoudi, FA & Kosiborod, M 2012, 'Relationship between glycosylated hemoglobin assessment and glucose therapy intensification in patients with diabetes hospitalized for acute myocardial infarction', Diabetes Care, vol. 35, no. 5, pp. 991-993. https://doi.org/10.2337/dc11-1839
Stolker, Joshua M. ; Spertus, John A. ; McGuire, Darren K ; Lind, Marcus ; Tang, Fengming ; Jones, Philip G. ; Inzucchi, Silvio E. ; Rathore, Saif S. ; Maddox, Thomas M. ; Masoudi, Frederick A. ; Kosiborod, Mikhail. / Relationship between glycosylated hemoglobin assessment and glucose therapy intensification in patients with diabetes hospitalized for acute myocardial infarction. In: Diabetes Care. 2012 ; Vol. 35, No. 5. pp. 991-993.
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