American Association for Clinical Chemistry
Better health through laboratory medicine
Heads Up: April 24, 2008

The Strategies Editorial Advisory Board recommends the following recent papers:

Glucometrics in Patients Hospitalized With Acute Myocardial Infarction. Defining the Optimal Outcomes-Based Measure of Risk

Measures of persistent hyperglycemia during acute myocardial infarction are better predictors of mortality than glucose measured upon admission to the hospital, a recent Circulation article concludes. Mean hospitalization glucose appears to be the most practical metric of hyperglycemia and hypoglycemia associated with adverse prognosis, write researchers, who note a J-shaped relationship between average glucose and mortality, with both persistent hyperglycemia and hypoglycemia associated with adverse prognosis.  

Comparison of Glycated Albumin and Hemoglobin A1c Levels in Diabetic Subjects on Hemodialysis

HbA1c levels significantly underestimate diabetic hemodialysis patients’ glycemic control, while glycated albumin more accurately reflects this control, notes a recent article in Kidney International. In patients with end-stage renal disease, lower HbA1c values were also associated with lower hemoglobin concentration and higher doses of erythropoietin a multicenter research team found.  

Prostate-Specific Antigen at or Before Age 50 as a Predictor of Advanced Prostate Cancer Diagnosed up to 25 Years Later: A Case-Control Study

A single PSA test taken by age 50 is a very strong predictor of advanced prostate cancer diagnosed up to 25 years later, suggesting that the test might be useful for finding men in need of intensive screening, according to a recent article in BMC Medicine. In patients younger than 50, total PSA was a strong and statistically significant predictor of subsequent advanced cancer, with AUC of 0.791. Two thirds of the advanced cancer cases occurred among men whose PSA levels were in the top 20%, at 0.9 ng/mL or higher.