Evaluation of the Glycosylated Haemoglobin as a Predictor of Severity of Coronary Artery Disease in Non-diabetic NSTEMI Patients

Cardiovascular Journal Pub Date : 2022-10-10 DOI:10.3329/cardio.v15i1.61907

Md Gulam Mostofa, Abdul Kader Akanda, M. Ullah, Md Zillur Rahman, Mohammad Mamoon Islam, M. Alam, Md. Ahsanul Haque, Suchitra Basak

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Abstract

Background: Glycated hemoglobin (HbA1c) values reflect two to three months average endogenous exposure haemoglobin to glucose including postprandial spikes and have low intra-individual variability particularly in non-diabetic patients. Elevated HbA1c is regarded as an independent risk factor for coronary artery disease (CAD) in patients with or without diabetes mellitus (DM). The purpose of this study is to determine the correlation between the level of HbA1c and the severity of coronary artery disease in non-diabetic non ST elevation myocardial infarction (NSTEMI) patients. Methods: This observational study was carried out with total of 64 non-diabetic patients with a history of NSTEMI. Patients were divided into 2 groups based on HbA1c - one group having HbA1c ³5.7 – 6.4% (High risk group) and another group with HbA1c < 5.7% (Low risk group). Severity of CAD was assessed using Gensini score derived from coronary angiographic data. Gensini score < 36 points was regarded as mild coronary artery disease and Gensini score 36 points as moderate to severe coronary artery disease. Then patients with high and low risk HbA1C groups were correlated with severity of CAD. Results: Over 55.5% patients with HbA1c in high-risk group (5.7 – 6.4%) had severe CAD as opposed to 28.6% patients with HbA1c in low-Risk group (<5.7%). The individuals with high-risk group of HbA1c was 3.1 (95% of CI = 1.1 – 8.9) times more likely to have severe CAD than those with HbA1c < 5.7% (p = 0.031). Spearman correlation between HbA1c and Gensini score depicted that the two variables exhibit a linear relationship indicating that Gensini score rises parallel with the rise of HbA1c (r = 0.289, p = 0.021). Conclusion: The study concluded that over half of the non-diabetic, NSTEMI patients with high-risk range HbA1c are likely to have severe CAD than those with HBA1c within normal range. Cardiovasc j 2022; 15(1): 26-35

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糖化血红蛋白作为非糖尿病非stemi患者冠状动脉疾病严重程度预测因子的评估

背景:糖化血红蛋白(HbA1c)值反映了2 - 3个月平均内源性血红蛋白对葡萄糖的暴露，包括餐后峰值，个体内变异性较低，特别是在非糖尿病患者中。HbA1c升高被认为是合并或不合并糖尿病(DM)患者冠状动脉疾病(CAD)的独立危险因素。本研究旨在探讨非糖尿病性非ST段抬高型心肌梗死(NSTEMI)患者HbA1c水平与冠状动脉疾病严重程度的相关性。方法:本观察性研究共纳入64例非糖尿病且有非stemi病史的患者。根据HbA1c分为两组，一组HbA1c³5.7 ~ 6.4%(高危组)，另一组HbA1c < 5.7%(低危组)。采用冠状动脉造影数据得出的Gensini评分来评估冠心病的严重程度。Gensini评分< 36分为轻度冠状动脉病变，Gensini评分36分为中重度冠状动脉病变。然后HbA1C高危组和低危组患者与冠心病严重程度相关。结果:超过55.5%的HbA1c高危组患者(5.7 - 6.4%)有严重的CAD，而28.6%的HbA1c低危组患者(<5.7%)有严重的CAD。HbA1c高危组发生严重冠心病的可能性是HbA1c < 5.7%组的3.1倍(95% CI = 1.1 ~ 8.9) (p = 0.031)。HbA1c与Gensini评分的Spearman相关性表明，两者呈线性关系，Gensini评分与HbA1c的升高同步升高(r = 0.289, p = 0.021)。结论:在HbA1c高危范围的非糖尿病、非stemi患者中，超过一半的患者比HbA1c正常范围的患者更容易发生严重的CAD。心血管病杂志[j] 2022;15(1): 26 - 35周不等

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Cardiovascular Journal

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