Relationship Between High Glycated Hemoglobin and Severity of Coronary Artery Disease in Type II Diabetic Patients Hospitalized With Acute Coronary Syndrome.

Abstract

IntroductionDiabetes mellitus (DM) is a chronic metabolic disease. It is the principal cause behind the high morbidity and mortality attributed to cardiovascular disease. This article’s objective was to determine a connection between high glycated haemoglobin levels (HbA1c) and coronary artery disease (CAD).Materials and MethodsCross-sectional research took place at the lady reading hospital, Peshawar, Pakistan, from 1st July 2020 to 31st December 2020. In this study, one hundred fifty-one type II diabetic patients took part. We labelled all of them as acute coronary syndrome (ACS) on arrival. Non-probability consecutive random sampling technique was used for sampling. We categorized patients based on their HbA1c levels into two groups. These groups included good glycemic control (HBA1c≤7. 5%) and patients with poor glycemic control (HBA1c ≥7.5%). We classified the angiographic results of these patients as normal coronary arteries (NCAs), single vessel disease (SVD), double vessel disease (DVD), and triple vessel disease (TVD). Continuous variables such as age, weight, height, and body mass index (BMI) between HBA1c levels were analyzed using the Mann-Whitney U test. The fisher’s exact test was performed to compare the categorical variables between the two classes.ResultsOf the total 151 patients, 89 (58.9%) were males, and the rest were female. The mean age was 55.4 ± 11.2 years. The most common risk factors were diabetes and hypertension, whereas ST-segment elevation myocardial infarction (STEMI) was the most common presentation. 107 (70.86%) patients had poor glycemic control (HbA1c>7.5%). Coronary angiographies showed TVD in 77 (50.99%) patients. Among these patients with TVD, 6 (14%) patients had good glycemic control, while 71 (66%) patients had poor glycemic control, which is significant (P≤0. 001). None of the patients with poor glycemic control had NCAs.ConclusionThis article found a link between high levels of HbA1c and the degree of coronary artery disease (CAD) among diabetic patients. Our study’s results demonstrated that high HbA1c was related to severe CAD. It would need additional studies with a large sample size to evaluate the more profound impact of HBA1c on coronary arteries.