IntroductionOur objective was to determine the severity frequency of coronary artery disease (CAD) in prediabetes patients undergoing coronary angiography (CAG) in a catheterization laboratory. Materials and methodsThis descriptive comparative study was conducted on patients who were planned for elective CAG in the hospital from January 2019 to November 2019. The study includes patients age ≥40 years undergoing elective CAG with or without percutaneous coronary intervention/percutaneous transluminal coronary angioplasty. There were 458 patients (381 men and 77 women) in this study that were categorized into three groups on the basis on their glycated hemoglobin (HbA1c) levels: group I (n = 143) as non-diabetes, group II (n = 110) as prediabetes, and group III (n = 205) as diabetes. The severity of CAD was determined using the Gensini score. ResultsA total of 458 patients were included. Of these, 44.97% had hypertension; n = 36 (25.17%), n = 48 (43.63%), and n = 122 (59.51%) in group I, group II and group III, respectively (P = .0001). A total of 214 (46.72%) had a smoking history. There was a strong family history of CAD in group II (n = 29, 26.36%) and group III (n = 43, 20.98%). Group II and group III patients had a higher extension of CAD than group I (P = .01). Group II (n = 27, 41.54) and group III (n = 65, 50.39%) had a higher frequency of deployment of two stents compared to group I. ConclusionCoronary artery atherosclerosis disease increases parallel to the HbA1c severity and smoking. The present study emphasizes prediabetes as an independent risk factor for CAD.