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World J Cardiol. Apr 26, 2014; 6(4): 140-147
Published online Apr 26, 2014. doi: 10.4330/wjc.v6.i4.140
Clinical significance of glycated hemoglobin in the acute phase of ST elevation myocardial infarction
Chiara Lazzeri, Serafina Valente, Marco Chiostri, Maria Grazia D’Alfonso, Gian Franco Gensini
Chiara Lazzeri, Serafina Valente, Marco Chiostri, Gian Franco Gensini, Maria Grazia D'Alfonso, Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero, Universitaria Careggi, 50134 Florence, Italy
Author contributions: Lazzeri C and Valente S designed the study and wrote the manuscript; Chiostri M and D'Alfonso MG collected the data; Gensini GF designed the study.
Correspondence to: Chiara Lazzeri, MD, Intensive Cardiac Care Unit, Heart and Vessel Department, Azienda Ospedaliero, Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. lazzeric@libero.it
Telephone: +39-55-7947518 Fax: +39-55-7947518
Received: November 25, 2013
Revised: March 5, 2014
Accepted: March 13, 2014
Published online: April 26, 2014
Processing time: 150 Days and 2.4 Hours
Core Tip

Core tip: Data on the prognostic role of glycated hemoglobin A1c (HbA1c) in patients with acute myocardial infarction (MI) are not univocal since they stem from studies which mainly differ in patients' selection criteria, therapy (thrombolysis vs mechanical revascularization) and number consistency. According to available evidence, in contemporary cohorts of ST-elevation myocardial infarction (STEMI) patients submitted to mechanical revascularization, HbA1c does not seem to be associated with short and long term mortality. However, in STEMI patients, HbA1c, even measured in the early phase, may represent a screening tool for glucose intolerance since its measurement can be performed in the non-fasting state and reflects average glucose concentration over the preceding 2-3 mo. We therefore proposed an algorithm based on pragmatic grounds which could be applied in STEMI patients without known diabetes in order to detect glucose intolerance abnormalities from the early phase. The main advantage of this algorithm is that it may help in tailoring the follow-up program, by helping in identifying patients at risk for the development of glucose intolerance after MI.