Value of testing glycated hemoglobin in non-diabetic patients presenting with acute coronary syndrome

Nanayakkara, Pavitra; Weerarathna, Thilak Priyantha; Herath, H. M. M.; Kariyawasam, A. G. T. A.; Ganegoda, V. R.

doi:10.4038/sjdem.v5i1.7265

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…The data in our study shows double the prevalence of diabetes in these patients. Our data is consistent with the results obtained by Nanayakkara et al [30] who showed 47% diabetic and 53% prediabetes in their study of similar patients. The higher incidence of diabetes in this study may be due to failure to detect diabetes early in the developing nations due to lack of community-based diabetes detection programme, ignoring the symptoms and lack of routine medical care or malignant nature of this disease along with other risk factors in Indian subcontinent population.…”

Section: Discussionsupporting

confidence: 94%

“…Similar results were obtained by correlation analysis between HbA1c and number of coronary vessels involved with Pearson correlation value of 0.566 and p value < 0.001. This data strongly supports the data from other emerging studies [10,30,33] strengthening the fact that besides diagnosing diabetes mellitus, HbA1c is strongly related with coronary artery disease and can be used as a marker of coronary artery disease and higher HbA1c levels predicting higher coronary artery disease burden.…”

Section: Discussionsupporting

confidence: 90%

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Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome

et al. 2020

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Background Acute coronary syndrome (ACS) indicates the serious clinical manifestation of coronary artery disease (CAD) and is closely associated with cardiovascular prognosis in patients with ACS. This study was aimed to study the prevalence of type 2 diabetes mellitus (T2DM) and the relation of HbA1c with the severity of CAD in patients presenting as non-diabetic ACS. Diabetic status of the patients was assessed with fasting blood sugar (FBS) and HbA1c levels, and coronary artery disease burden was assessed by coronary angiography. Results Out of 208 patients, 85.1% were males, and 14.9% were females; 73.56% cases were hypertensive. 80.77% of cases had STEMI, 17.79% had NSTEMI, and 1.44% had unstable angina. Out of 168 STEMI patients, 64.3% were thrombolysed, 21.42% presented late, 2.38% had contraindications to thrombolysis, and 11.9% underwent primary PCI. FBS in diabetic range was found in 44.23% of cases, impaired FBS in 36.54%, and 19.23% of patients had FBS in non-diabetic range. According to HbA1c, 41.8% were diabetic, 39.4% were pre-diabetic, and 18.8% were non-diabetic. A significant positive correlation was found between HbA1c and Gensini score and between HbA1c and the number of vessels involved. Conclusion This study emphasises the importance of evaluating the presence of diabetes in patients presenting as non-diabetic acute coronary syndrome in developing countries. Acute coronary syndrome may be considered as one of the presentations of diabetes mellitus.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 90%

Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome

et al. 2020

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“…In our study 52.5% of patients are diabetic and 27% are prediabetic, these findings are comparable with study conducted by Nanayakkara et al 18 reporting 47% diabetic and 53% prediabetics. Nevertheless, efforts are being made to build the necessary infrastructure for implementing the pharmaceutical invasive strategy, which calls for early identification of MI, that encourages the thrombolysis at peripheries whenever necessary early referral of patients to tertiary care center with facility of percutaneous coronary intervention is available.…”

Section: Discussionsupporting

confidence: 92%

Association between HBA1C and Coronary Artery Disease Severity in patients of Diabetes Mellitus Type 2 presented as Acute Coronary Artery Syndrome and Non Diabetic

Qadir¹,

Khan²,

Khan³

et al. 2022

PJMHS

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Aim: to investigate the prevalence of diabetes mellitus type 2 (T2DM) and association of HbA1c with the severity of coronary artery disease (CAD) in patients presenting at tertiary care center as acute coronary syndrome and non-diabetic. Study Design: Prospective observational study Duration and Place Study was conducted at department of general medicine Nishter Hospital, Multan from January 2021 to January 2022 in 1 year duration. Methodology: A total of 200 patients were enrolled in study. Main variables of study were BMI, smoking status, dyslipidemia, hypertension, STEMI, angina, HbA1c and treatment strategy. SPSS version 23 was used for data analysis. P value below or equal to 0.05 was taken as significant. Results: Among total 83.5% patients intervened by therapeutic, whereas 48.0% used thrombolytic drug in STEMI. 70.7% patients were thrombolysis in therapeutic intervention and 44.8% were streptokinase in thrombolytic drug. In fasting blood sugar, 53.0% patients were diabetic, whereas in HbA1c levels, 52.3% patients were diabetic. Conclusion: This study highlights the significance of testing for diabetes in individuals in poor nations who report with non-diabetic acute coronary syndrome. One of manifestations of diabetes mellitus may be the acute coronary syndrome. Keywords: Acute coronary syndrome, Coronary angiography, Diabetes, HbA1c.

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“…We observed positive significant correlations between Spearman's correlation between HbA1c with stenosis in coronary arteries (Table 4). These results are strongly supported by recent studies conducted [20,21].…”

Section: Discussionsupporting

confidence: 90%

Type 2 diabetes mellitus and coronary artery stenosis: a risk pattern association study

Shrivastav

Dabla

Singh

et al. 2023

Exploration of Medicine

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Aim: Cardiovascular diseases (CVD) are the leading cause of death globally. In the condition of type 2 diabetes mellitus (T2DM), the prevalence of CVD increase parallel with the rise of metabolic complication and higher incidence of coronary artery stenosis. The aim of this study was to compare the level of percent stenosis in coronary arteries in patients with coronary artery disease (CAD) with and without T2DM, and to measure the severity of CVD using Gensini score (GS) through angiographic data. Methods: The current study was conducted in tertiary care specialized hospital in Delhi, India. The level of percent stenosis in coronary arteries was compared in patients with CAD with and without T2DM. The patients were divided into two groups: group I included 100 patients with T2DM, and group II included 100 non-diabetic CAD patients who underwent coronary angiography by Judkin’s technique. The severity of CVD was measured by GS through angiographic data. The serum levels of glycated haemoglobin (HbA1c) ≥ 6.5% were considered diabetic. Results: Significant difference was observed in serum HbA1c, and random blood sugar levels between group I and group II were also observed (P ≤ 0.001). Serum HbA1c shows a significant positive association with GS (r = 0.36, P = 0.007). Conclusions: The study shows a significant level of stenosis in coronary arteries of CAD diabetic patients. However, further prospective analysis of a larger population size will be needed to strengthen the findings and the significant association.

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Value of testing glycated hemoglobin in non-diabetic patients presenting with acute coronary syndrome

Cited by 3 publications

References 10 publications

Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome

Prevalence of type 2 diabetes mellitus and association of HbA1c with severity of coronary artery disease in patients presenting as non-diabetic acute coronary syndrome

Association between HBA1C and Coronary Artery Disease Severity in patients of Diabetes Mellitus Type 2 presented as Acute Coronary Artery Syndrome and Non Diabetic

Type 2 diabetes mellitus and coronary artery stenosis: a risk pattern association study

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