Observational studyCardiovascular diabetology2021
J-curve relationship between long term glycemic control and mortality in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention.
Observational study in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Hemoglobin A1c association patterns with cardiovascular outcomes among patients with diabetes mellitus following percutaneous coronary intervention: A systematic review.Diabetes & vascular disease researchPooled it
- Glycemic control and renal function decline in patients with chronic coronary syndrome: A multicenter cohort study.Journal of diabetes investigation · 2026Observational
- Comparison of Clinical Outcomes between Newly Diagnosed and Pre-Existing Diabetes Mellitus Patients after Acute Coronary Syndrome.Current vascular pharmacology · 2026Article
- Interplay of glycated hemoglobin and traditional risk factors for the risk of atherosclerotic cardiovascular disease and all-cause mortality in people without diabetes.Cardiovascular diabetology · 2025Observational
- Associations of diabetes status and glucose measures with outcomes after endovascular therapy in patients with acute ischemic stroke: an analysis of the nationwide TREAT-AIS registry.Frontiers in neurology · 2024Article
- Intensified glycemic control by HbA1c for patients with coronary heart disease and Type 2 diabetes: a review of findings and conclusions.Cardiovascular diabetology · 2023Review
Corrections and comments
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Authors and funding
19 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntensive glycemic control is generally recommended for diabetic patients to reduce complications. However, the role of glycemic control in the mortality in diabetic patients with acute myocardial infarction (AMI) remained unclear.
methodsWe selected diabetic patients who measured HbA1c more than 3 times after AMI among 10,719 patients enrolled in the multicenter AMI registry. Patients (n = 1384) were categorized into five groups: according to mean HbA1c level: ≤ 6.5%, > 6.5 to ≤ 7.0%, > 7.0 to ≤ 7.5%, > 7.5 to ≤ 8.0% and > 8.0%. The primary endpoint was all-cause mortality.
resultsDuring a median follow-up of 6.2 years, the patients with a mean HbA1c of 6.5 to 7.0% had the lowest all-cause mortality. Compared to patients with mean HbA1c of 6.5 to 7.0%, the risk of all-cause mortality increased in subjects with mean HbA1c ≤ 6.5% (adjusted hazard ratio [HR] 2.00, 95% confidence interval [CI] 1.02-3.95) and in those with mean HbA1c > 8.0% (adjusted HR 3.35, 95% CI 1.78-6.29). In the subgroup analysis by age, the J-curve relationship between mean HbA1c and all-cause mortality was accentuated in elderly patients (age ≥ 65 years), while there was no difference in all-cause mortality across the HbA1c groups in younger patients (age < 65 years).
conclusionsThe less strict glycemic control in diabetic patients with AMI would be optimal for preventing mortality, especially in elderly patients.
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