Key result
Severely elevated HbA1c in ACS is linked to a ~42% incidence of triple vessel disease.
Why the study?
High HbA1c reflects long-term glycemic control and may correlate with CAD severity, prompting this evaluation of HbA1c levels and angiographic patterns in patients admitted with ACS.
Does elevated HbA1c correlate with increased severity of coronary artery disease in patients with acute coronary syndrome and diabetes mellitus?
Cross-Sectional (n=120)
No
Does elevated HbA1c correlate with increased severity of coronary artery disease in patients with acute coronary syndrome and diabetes mellitus?
Absolute Event Rate: 41.7% vs 3.3%
p-value: p=0.019
In patients with acute coronary syndrome and diabetes, elevated HbA1c levels are strongly associated with more severe and complex coronary artery disease, highlighting the importance of glycemic control in mitigating atherosclerosis.
May flag higher CAD complexity in ACS; leaves open whether glycemic optimization alters angiographic severity.
Background The relation of diabetes mellitus with cardiovascular diseases is well-known, even acute coronary syndrome (ACS). High levels of glycated haemoglobin (HbA1c) are used is a sign of long-term glycemic control and may be associated with severity in coronary artery disease (CAD). In this particular setting, the aim of this investigation was to examine the relationship between the HbA1c values and the angiographic patterns of patients who were admitted with an ACS diagnosis. Methodology A cross-sectional study included 120 patients diagnosed with ACS. The criteria for eligibility included patients with ST-elevation myocardial infarction, unstable angina, and non-ST elevation myocardial infarction with history of documented diabetes mellitus. Every patient had a suitable clinical examination, had their HbA1c checked, and had coronary angiography to determine the severity of their CAD. Descriptive statistics and ANOVA were performed for statistical analyses to determine the connection between angiographic patterns and HbA1c. Results Patients with elevated HbA1c levels demonstrated a strong association with severe coronary artery disease. Notably, those with HbA1c exceeding 10.5% exhibited significant triple vessel disease and Type C lesions, indicative of advanced coronary artery disease. Statistical analyses revealed a marked difference in angiographic patterns across various HbA1c categories (p < 0.05). Conclusion The findings of this study suggest that maintaining optimal HbA1c levels is essential for mitigating the severity of coronary artery disease in patients with ACS. Moreover, effective glycemic control may be protective against advanced coronary atherosclerosis and subsequent cardiovascular complications in both diabetic and non-diabetic individuals.
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Garg et al. (2024) conducted a cross-sectional in Acute Coronary Syndrome with Diabetes Mellitus (n=120). Elevated HbA1c levels (>10.5%) vs. Lower HbA1c levels (<6.5%) was evaluated on Incidence of Triple Vessel Disease (TVD) (p=0.019). In patients with acute coronary syndrome, elevated HbA1c levels (>10.5%) were significantly associated with severe coronary artery disease, including a 41.7% incidence of triple vessel disease compared to 3.3% in those with HbA1c <6.5%.
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