Dataset Information

Impact of diabetes mellitus and hemoglobin A1c level on outcomes among Chinese patients with acute coronary syndrome.

ABSTRACT:

Background

The impact of different glycemic control conditions on in-hospital and long-term outcomes among patients with acute coronary syndrome (ACS) is less well defined.

Hypothesis

Diabetes mellitus (DM) with different admission hemoglobin A1c (HbA1c) levels (different glycemic control) could affect outcomes among Chinese patients hospitalized as ACS.

Methods

We categorized 8961 Chinese ACS patients into one of the following three groups: "no DM" (group 1, n = 3773; no DM history and admission HbA1c < 6.5%), "DM with optimal control"(group 2, n = 2241; DM with admission HbA1c < 7.0%), "DM with suboptimal control"(group 3, n = 2947; DM with admission HbA1c ≥ 7.0%). The primary outcome was in-hospital major adverse cardiovascular events (MACEs). 6098 patients were followed for a median of 3.85 years. Adjusted associations of these three groups with in-hospital MACEs and long-term mortality were determined.

Results

DM with suboptimal control (group 3) was associated with greater in-hospital MACEs (OR 1.46, 95% CI 1.17-1.81, P = .001) than "no DM" (group 1). DM patients (group 2 and group 3) also had higher in-hospital MACEs (OR 1.42, 95% CI 1.16-1.73, P = .001) than "no DM" patients (group 1). It showed no significantly different in-hospital MACEs between optimal (group 2) and suboptimal (group 3) control group (OR 1.06, 95% CI 0.84-1.34, P = .63). Both optimal control (group 2) and suboptimal control (group 3) had a higher long-term mortality (HR 1.26, 95% CI 1.02-1.56, P = .03; HR 1.42, 95% CI 1.16-1.73, P = .001).

Conclusions

ACS patients with DM were associated with higher in-hospital MACEs and long-term mortality. Moreover, lower HbA1c level seems to have limited impact on cardiovascular events and long-term mortality in this high-risk population.

SUBMITTER: Xiong R

PROVIDER: S-EPMC7368303 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of diabetes mellitus and hemoglobin A1c level on outcomes among Chinese patients with acute coronary syndrome.

Xiong Ran R He Liu L Du Xin X Dong Jian-Zeng JZ Ma Chang-Sheng CS

Clinical cardiology 20200519 7

<h4>Background</h4>The impact of different glycemic control conditions on in-hospital and long-term outcomes among patients with acute coronary syndrome (ACS) is less well defined.<h4>Hypothesis</h4>Diabetes mellitus (DM) with different admission hemoglobin A1c (HbA1c) levels (different glycemic control) could affect outcomes among Chinese patients hospitalized as ACS.<h4>Methods</h4>We categorized 8961 Chinese ACS patients into one of the following three groups: "no DM" (group 1, n = 3773; no D ...[more]

PMID: 32427378

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Project description:High-fiber diet interventions have been proven to be beneficial for gut microbiota and glycemic control in diabetes patients. However, the effect of a low level of fiber in habitual diets remains unclear. This study aims to examine the associations of habitual dietary fiber intake with gut microbiome profiles among Chinese diabetes patients and identify differential taxa that mediated associations of dietary fiber with HbA1c level. Two cross-sectional studies and one longitudinal study were designed based on two follow-up surveys in a randomized trial conducted during 2015-2017. The study included 356 and 310 participants in the first and second follow-ups, respectively, with 293 participants in common in both surveys. Dietary fiber intake was calculated based on a 3-day 24-h diet recall at each survey and was classified into a lower or a higher group according to the levels taken based on the two surveys using 7.2 g/day as a cut-off value. HbA1c was assayed to assess glycemic status using a cut-off point of 7.0% and 8.0%. Microbiome was profiled by 16S rRNA sequencing. A high habitual dietary fiber intake was associated with a decrease in α-diversity in both the cross-sectional and longitudinal analyses. At the first follow-up, phylum Firmicutes and Fusobacteria were negatively associated with a higher dietary fiber intake (p < 0.05, Q < 0.15); at the second follow-up, genus Adlercreutzia, Prevotella, Ruminococcus, and Desulfovibrio were less abundant in patients taking higher dietary fiber (p < 0.05, Q < 0.15); genus Desulfovibrio and Ruminococcaceae (Unknown), two identified differential taxa by HbA1c level, were negatively associated with dietary fiber intake in both the cross-sectional and longitudinal analyses, and mediated the dietary fiber-HbA1c associations among patients taking dietary fiber ≥ 7.2 g/day (mediation effect β [95%CI]: -0.019 [-0.043, -0.003], p = 0.018 and -0.019 [-0.046, -0.003], p = 0.016). Our results suggest that habitual dietary fiber intake has a beneficial effect on gut microbiota in Chinese diabetes patients. Further studies are needed to confirm our results.

Dataset Information

Impact of diabetes mellitus and hemoglobin A1c level on outcomes among Chinese patients with acute coronary syndrome.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Impact of diabetes mellitus and hemoglobin A1c level on outcomes among Chinese patients with acute coronary syndrome.

Similar Datasets

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