Severity of atherosclerotic coronary artery disease in relation to glycated hemoglobin level in diabetic patients

ObjectiveThe aim of this work was to assess the relationship between the level of glycated hemoglobin (HbA1c) and the severity of coronary artery disease (CAD) among diabetic patients and perform a comparison with nondiabetic patients.BackgroundDiabetes mellitus and coronary heart disease are closely associated and generally coexist. The severity CAD is directly related to the quality of glucose control in diabetic patients.Patients and methodsThis study included 150 patients referred to coronary angiography. In addition to the routine evaluation, assessment of HbA1c level, transthoracic echocardiogram, and coronary angiography were performed and the Gensini score (GS) was calculated. Diabetic patients were classified as controlled and uncontrolled on the basis of the cut-off point of HbA1c value of 7%. Nondiabetic patients were classified as low-risk and high-risk groups.ResultsAmong the patients, 64.7% had diabetes mellitus and 54.7% were hypertensive. Also, 74.23% of the patients in the diabetic group had HbA1c greater than or equal to 7 mg%, with a mean HbA1c of 9.7 ± 2.2. The mean GS was 41 ± 31.3. There was a significant positive correlation between the level of HbA1c and fasting plasma glucose (r = 0.454, P = 0.000), waist–height ratio (r = 0.19, P = 0.045), regional wall motion score index (r = 0.23, P = 0.019), and GS (r = 0.312, P = 0.049) (in the diabetic group). Also, in the nondiabetic group, there was a significant correlation between HbA1c, GS (r = 0.448, P = 0.032), fasting plasma glucose (r = 0.470, P = 0.000), and weight (r = 0.264, P = 0.046).ConclusionHbA1c level is a useful biomarker and has prognostic value to predict the severity of CAD among diabetic and nondiabetic patients.