Many prevention specialists believe that we are not diagnosing diabetes early enough if we wait for hemoglobin A1c (HbA1c) levels to reach ≥ 6.5%. Filepe Moura and colleagues sought to find out if there was a relationship between HbA1c levels in non-diabetic ST-elevation myocardial infarction (STEMI) patients and recurrent cardiac events. Data, from a prospective cohort of 326 patients, reviewed by the investigators included plasma glucose, HbA1c, nitrate/nitrite (NOx), and C-reactive protein (CRP). At 30 days post-STEMI, flow-mediated dilation (FMD) was also measured. Incidence of progression to diabetes (HbA1c levels ≥ 6.5%) and major adverse cardiac events (MACE) defined as angina requiring hospitalization, fatal and non-fatal myocardial infarction, and sudden cardiac death was recorded during the follow-up period. A ROC-analysis revealed that a HbA1c of 5.8% best predicted MACE. Patients were divided into two groups based on HbA1c levels : those with ≥ 5.8% as high HbA1c and those with levels <5.8% as low HbA1c. Patients who fell into the high group also had significantly higher CRP and NOx levels and a 33% lower FMD. The authors found markers of increased inflammation and endothelial dysfunction in these patients who had HbA1c ≥ 5.8% and concluded that this group of non-diabetic STEMI patients also had a higher long-term risk of MACE.