Choi IJ, Choo EH, Kim HJ, et al. - The less strict glycemic control would represent an optimal strategy for preventing mortality in diabetic patients with acute myocardial infarction (AMI), especially in elderly patients.

• Using the multicenter AMI registry, a total of 1384 diabetic patients who measured glycated hemoglobin (HbA1c) more than 3 times after AMI were analyzed.

• A median follow-up of 6.2 years revealed the lowest all-cause mortality in patients with a mean HbA1c of 6.5 to 7.0%.

• Relative to patients with mean HbA1c of 6.5 to 7.0%, an elevated risk of all-cause death was found in those with mean HbA1c ≤ 6.5% (adjusted hazard ratio [HR] 2.00) and in those with mean HbA1c > 8.0% (adjusted HR 3.35).

• In elderly patients (age ≥ 65 years), the J-curve association between mean HbA1c and all-cause death was accentuated, while no difference in all-cause mortality was identified across the HbA1c groups in younger patients (age < 65 years).