ROLE OF GLYCOSYLATED HEMOGLOBIN (HBA1C) IN DIABETICS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION (AMI) ON B-TYPE NATRIURETIC PEPTIDE (BNP) AND ITS CORRELATION WITH LEFT VENTRICULAR FUNCTIONS

Abstract

Objective: To determine the effect of glycosylated hemoglobin (HbA1c) on theleft ventricular (LV) functions and plasma B-type natriuretic peptide (BNP) levelsin type 2 diabetic patients (T2DM) who presented with acute myocardialinfarction (AMI).

Methodology: This cross-sectional study was conducted on patients withpreviously known T2DM admitted after first episode of AMI in department ofcardiology, Lady Reading Hospital (LRH) and Rehman Medical Institute (RMI),Peshawar from 1st November 2014 to 30th June 2015. Subjects weredichotomized on the basis of admission HbA1c; HbA1c ≤ 7% was taken asoptimal control group and HbA1c > 7% was taken as suboptimal control group.

Results: A total of 196 patients were included in the study. About 35(17.85%)subjects had optimal glycaemic control, compared to 161 (82.15%), who hadsuboptimal glycaemic control. BNP levels were significantly higher in suboptimalcontrol group compared to optimal group (351.8±419.46 pg/ml vs567.2±444.35 pg/ml, p = 0.009). A negative correlation between HbA1c andejection fraction (r = -0.3, p = <0.00 for optimal control group and r = -0.4, p =0.01 for suboptimal control group) and between HbA1c and fractional shortening(r = -0.4, p = 0.01 for optimal control group and r = -0.3, p = <0.00 forsuboptimal control group) was found.

Conclusion: This study suggests that HbA1c has significant impact on plasmaBNP levels and optimal HbA1c levels in Type 2 diabetic patients result in improvedLV systolic functions after AMI.