Soheb Rehman, Abdus Sattar Khan, Mohammad Hafizullah, Aalia Amjad.
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.
Pak Heart J Jan ;49(4):139-45.

Objective: To determine the effect of glycosylated hemoglobin (HbA1c) on theleft ventricular (LV) functions and plasma B-type natriuretic peptide (BNP) levels in type 2 diabetic patients (T2DM) who presented with acute myocardial infarction (AMI). Methodology: This cross-sectional study was conducted on patients with previously known T2DM admitted after first episode of AMI in department of cardiology, Lady Reading Hospital (LRH) and Rehman Medical Institute (RMI),Peshawar from 1st November 2014 to 30th June 2015. Subjects were dichotomized on the basis of admission HbA1c; HbA1c <= 7% was taken as optimal 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 glycemic control, compared to 161 (82.15%), who had suboptimal glycaemic control. BNP levels were significantly higher in suboptimal control 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 and ejection 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 for suboptimal control group) was found. Conclusion: This study suggests that HbA1c has significant impact on plasma BNP levels and optimal HbA1c levels in Type 2 diabetic patients result in improved LV systolic functions after AMI.

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