The Role of Glycated Hemoglobin A1c in Determining the Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Subjects in Karachi

Abstract

Introduction Coronary artery disease is the leading cause of death worldwide by incidence. Over the years, many studies have been conducted to find predictors of coronary artery disease; however, in the last few decades, the level of HbA1c in diabetics has been investigated as a potential predictor. Our study offers additional insight by investigating similar relationships in non-diabetic patients and by investigating potential predictors more comprehensively, making it the first of its kind study. The aim of our study is to indicate that rising HbA1c levels suggest that there’s a greater risk of coronary artery disease, which can further be confirmed by the SYNTAX score, degree of stenosis, and numbers of vessels involved. Methods Data from 177 diabetic and 378 non-diabetic patients, all of whom were above 18 years of age, were included in the research. HbA1c levels (>5.6%), SYNTAX score, hypertension, number of vessels involved, and other demographic elements, such as age, smoking, and body measurements, were calculated and compared for diabetics and non-diabetics. Results HbA1c was higher in comparison to non-diabetic subjects (p <0.001). Age >53 was found to be a predictor for SYNTAX score ≥23 in diabetic patients (p <0.05). Male gender and smoking were found to be independent predictors for three-vessel disease in the non-diabetic population (p-value<0.05). There was no significant relationship between the SYNTAX score and HbA1c levels in non-diabetics (p=0.885) and diabetics. In conclusion, there is no correlation between elevated HbA1c levels and SYNTAX score ≥23.

Hemoglobin A1c and Angiographic Severity with Coronary Artery Disease: A Cross-Sectional Study

“…With increasing HbA1c levels, a marked increase in SYNTAX score was noted in the patients without a history of taking Statins Epidemiologic studies show that HbA1c is a cardiovascular risk factor in all kinds of individuals. [3][4][5][6][7][8][9][10] Our findings are in accordance with prior studies that demonstrated that HbA1c levels are independently associated with SYNTAX score which represents the degree of coronary atherosclerosis in non-diabetic and diabetic individuals. This association is graded, continuous, and independent of conventional major cardiovascular risk factors and history of taking cardiovascular related drugs.…”

“…There are lots of researches elaborating the effects of glycemic metabolism on CAD. 2–10 These studies show that HbA1C were correlated positively with the Severity of CAD in different groups of people, such as older patients with diabetes mellitus, 8 Type 2 Diabetes Mellitus, 7 Non-Diabetic Subjects, 4 , 6 Diabetic and Non-Diabetic Subjects, 3 , 9 PCI Patients With HbA1c 5.7% to 6.4 10 and Non-diabetic Patients with Acute Coronary Syndrome 5 . However, previous studies regarding the relationship between HbA1c and SYNTAX score just adjusted some conventional risk factor, not adjusted conventional cardiovascular drugs.…”

Association of Telomere Length and Serum Vitamin D Levels with Type 2 Diabetes Mellitus and its Related Complications: A Possible Future Perspective

“…and Ul-Haque et al . [ 34 35 ] Further, the HbA1c level was positively co-related with BMI in diabetic patients ( r = 0.38; P = 0.0107) in line with the findings by Babikr et al . [ 36 ] Moreover, correlation was similar and significance between HbA1c and FBS, PPBS between both the groups ( P < 0.0001) was with a higher r-value for PPBS than the FBS in the nondiabetic group.…”