Prognostic Significance of HbA1c Level in Asian Patients with Prediabetes and Coronary Artery Disease

Abstract

Background: Measuring glycosylated hemoglobin (HbA1c) is a simple way to assess patients with prediabetes or diabetes mellitus. It has been shown that HbA1c level predicts prognosis in patients with coronary artery disease (CAD) and the incidence of diabetes mellitus. However, the prognostic significance of HbA1c level in Asian patients with prediabetes and CAD is not yet clear. Our study aimed to determine the relationship between HbA1c level and major adverse cardiovascular events (MACE) in patients with prediabetes and CAD. Methods: We enrolled 1367 patients with prediabetes and CAD in the final analysis, and grouped them according to the HbA1c level. Primary end points included nonfatal myocardial infarction, hospitalization for unstable angina, and ischemia-driven revascularization. Cox proportional-hazards regression analysis was used to determine the relationship between HbA1c level and MACE after our accounting for confounding factors. Results: A total of 1367 patients (age 58.8 ± 10.3 years; 71.6% men) were included. During 43 months of follow-up, 197 patients experienced at least one primary end point event. Multivariate Cox proportional-hazards regression analysis showed in comparison of HbA1c levels that the hazard ratio for primary end points was 4.110, with a 95% confidence interval of 2.097–6.011 (P<0.001). Conclusions: HbA1c level positively correlated with MACE, demonstrating it is a valuable indicator for independently predicting MACE in Asian patients with prediabetes and CAD.