Features of the Trajectories of Glycated Hemoglobin in Patients with CHD and DM 2

Abstract

IntroductionMaintaining a stable level of glycated hemoglobin (HbA1c) is considered as a guarantee of preventing micro- and macrovascular complications. Purposeanalysis of the interrelations of clinical and anamnestic parameters as a result of HbA1c alternation variants in patients with CHD and DM 2. Material and methods130 patients with CAD and DM-2 aged 63.9±8.8 years. Therapy: DPP-4 inhibitors, GLP agonists. Groups: HbA1c <7.0 (n-27; A); 7.0<HbA1c<8.0 (n-25; B); HbA1c > 8.0 (n-78; C). 2 years of observation. ResultsVariants of HbA1c alternation were noted. Patients were identified who maintained stable HbA1c>8.1 (C, n-50) and HbA1c<8 (A+B, n-47) and alternating HbA1c>8.1 (C´, n-5) and in whom HbA1c>8.1, became <8 (C-(A+B), n-28). The frequency of paroxysmal AF and stroke (TIA) increases with a decrease in HbA1c. The number of patients who underwent COVID is higher with HbA1c <8 and 2.2 times more often with unstable levels. In group (C), the greatest efficiency in reducing SBP was 34 mm Hg (p=0.0357); and DBP 11.7 (p=0.0003). ConclusionThe two-year dynamics of HbA1c in 75% is maintained at the target values >8.1% in 38.4% and in 36.15% - <8%. Patients with a history of COVID are higher in the group with HbA1c<8 and 2.2 times more likely in its various "trajectories". The incidence of paroxysmal AF and stroke increases with a decrease in HbA1c, but in AF depends on HbA1c trajectories, but not in stroke. The frequency of AMI, PCI, CABG has no relationship with the level of HbA1c.