Artery Disease In Nondiabetic Patients Research Articles

Association of hemoglobin A1c and severity of coronary arteries disease in non-diabetic patients undergoing coronary arteries angiography: A cross-sectional study

Objective: The aim of this study was to determine the association of HbA1c with coronary artery disease (CAD) in non-diabetic patients undergoing coronary artery angiography. Methods: This cross-sectional study was conducted on 265 individuals referred to an educational heart hospital affiliated with Urmia University of Medical Sciences, north of Iran. Participants were selected through a convenient sampling method. Patients underwent angiography, and CAD disease severity for them was computed using a GSS score. The association of HbA1c and other variables on CAD disease severity was investigated. Results: A total of 265 non-diabetic diabetic patients with a mean age of 59.36 years were investigated. The mean body mass index was 26.42 kg/m2 and the mean left ventricular ejection fraction (LVEF) was 48.62%. The mean score of the Geriatric Scoring System in patients was 31.28. As the GSS score increased, HbA1c was significantly increased as well. HbA1c had an appropriate value in the diagnosis of severe CAD, and the best cutoff point for this assessment was 6.15%. In addition, HbA1c had an appropriate value in the diagnosis of mild CAD, but cigarette use and hypertension had no significant effect on this association. Conclusion: HbA1c with cutoff points mentioned was an appropriate factor to determine the severity of CAD in non-diabetic patients; therefore, it is recommended to use that to determine disease severity, and in patients with high levels of HbA1c, close follow-up and treatment need to be done to decrease the complications and mortality.

Relationship between Urinary Albumin Creatinine Ratio and Severity of Coronary Artery Disease in Non-Diabetic Patients

Background: Coronary artery disease (CAD) is leading cause of mortality worldwide. CAD accounts for 20% of all deaths in the South Asia region. The burden of CAD is emerging as a public health concern in developing countries like Bangladesh. There are some new biomarkers for detection of CAD. The aim of this study was to find out the relationship between ACR and severity of coronary artery disease in non-diabetic.Material & Methods:This cross-sectional analytical study was conducted in the department of cardiology, National Heart Foundation Hospital and Research Institute from April, 2018 to March, 2019. Purposive sampling was done to select a total 101 study subjects. Data were collected in a predesigned data collection form through clinical history, examination, laboratory findings and coronary angiogram report. Study population was divided into two groups: Group–A: Non-diabetic patients with ACR > 30mg/g Group–B: Non-diabetic patients with ACR ≤ 30mg/g.Results:Participants had a mean age of 52.5 ± 9.9 years with 75.24% men. Group A patients had higher ACR level (49.98±15.83 vs 13.36±7.08; p<0.01) than group B patients. Relation between urinary ACR and severity of CAD remained significant. Conclusions:In this study, there found a significant relationship in ACR and severity of coronary artery disease in non-diabetic patients.

Evaluation of monocyte/lymphocyte ratio, CRP/albumin ratio and glycated hemoglobin to predict the severity of coronary artery disease in non-diabetic patients: Correlation with SYNTAX SCORE

Evaluation of monocyte/lymphocyte ratio, CRP/albumin ratio and glycated hemoglobin to predict the severity of coronary artery disease in non-diabetic patients: Correlation with SYNTAX SCORE

Evaluation of the association between glycated hemoglobin levels and severity of coronary artery disease in nondiabetic patients

Introduction: Higher fasting blood glucose level plus raised glycated hemoglobin (HbA1c) levels is one of the major risk factors for cardiovascular (CV) events in nondiabetic population. HbA1c levels have low intra-individual variability especially in nondiabetic patients. Studies have shown that coronary artery disease (CAD) and HbA1c are predictors of CV mortality. In this study, we have evaluated the association between HbA1c and severity of CAD in nondiabetic patients. Materials and Methods: This is a hospital-based observational study done on 300 patients in Department of Medicine and Department of Cardiology, Mahatma Gandhi Medical College and Hospital, Jaipur. Prior approval was taken before the start of study from the Institute Ethics Committee. Gensini score was used to estimate the CAD severity. This score is based on the sum of scores for all 3 coronary arteries to assess the entire extent of CAD. Data were analyzed and appropriate statistical tests were used. P < 0.05 were considered statistically significant. Results: This study showed that the majority of cases (59.33%) were seen in 51–70 years of age group. The maximum number of patients (66.66%) had 5.6–6.5 HbA1c level and 29.36 ± 19.50 Gensini score in our study. Mean Gensini score showed a linear relationship with HbA1c. Conclusion: HbA1c level has a prognostic value for predicting the severity of CAD among nondiabetic patients and can act as a useful marker in risk stratification of nondiabetic patients presenting with acute coronary syndrome and indicated for angiographic evaluation.

Role of Left Ventricular Speckle Tracking Imaging in Detection of Coronary Artery Disease in Non-Diabetic Patients

This study aimed to determine the role of global longitudinalstrain (GLS) in early diagnosis and detection of severity of coronaryartery disease (CAD) in non-diabetic patients with preservedleft ventricular ejection fraction (EF) without regionalwall motion abnormalities presented with chronic coronary syndrome,and to identify the role of territorial longitudinal strain(TLS) in detection of the affected coronary artery. We enrolled60 non-diabetic patients with suspected CAD who underwentresting echocardiography and speckle tracking imaging andsubsequently coronary angiography then results were correlatedtogether. Patients with family history of CAD (68.3%), hypertension(68.3%), smokers (43.3%), and dyslipidemia (81.6%). Allparticipants had normal left ventricular systolic function withmean EF of 64.02±6.15% and no regional wall motion abnormalitiesat rest. Patients were classified angiographically accordingto the number of the diseased vessels into: 3 vessels disease(43.3%), 1-2 vessels disease (35%), and normal coronaryangiography (21.7%) with GLS mean values of -13.69±1.94%,-15.4±1.74%, and -18.80±2.14%, respectively. There was a negativesignificant correlation between GLS values and the numberof diseased vessels (P=0.001). The values of TLS were significantlylower in myocardial regions supplied by stenotic arteries thanthose supplied by non-stenotic arteries. Mean TLS values forstenotic left anterior descending, left circumflex, and right coronaryarteries were -15.51±3.19, -13.06±2.90, -13.27±2.60 withP=0.011, 0.001, and 0.001, respectively. Speckle tracking derivedGLS is an effective non-invasive method in predicting presenceand severity of CAD and in locating the affected vessels basedon the distribution of segments affected in TLS.

CT coronary angiography in Selected Group of patients with Chest pain of new onset predicts and prevents hospital admissions & Outpatient Clinic referrals

Abstract Funding Acknowledgements Type of funding sources: None. Introduction NICE (National Institute of Clinical Excellence) guidelines currently recommend the use of CT coronary Angiogram (CTCA) as the initial test to investigate coronary artery disease in patients with new onset of chest pain. Our aim was to evaluate the relationship between the CT coronary angiogram findings on index presentation, and hospital admissions and re-referral to outpatient clinics in following 2 years. Method Data was accrued via a retrospective analysis of electronic medical records at Sunderland Royal Hospital pertaining to patients who presented to the Rapid Access Chest Pain Clinic (RACPC) and underwent CTCA in 2017.Data included: Presentation – Typical & atypical angina Risk factors profile Investigations including ECG, ECHO, CTCA, perfusion scan and invasive coronary angiography Severity of coronary artery lesion on CTCA Hospital admissions or re-referral to outpatient clinics in 2 year follow up Results In the 235 patients studied, mean age was 56 years with 130 (55.5%) men and 195 (82.9%) presented with atypical angina as shown in table. Out of 195 patients with atypical chest pain only 17 (8.7%) were diabetics and most of them 178 (91%) had Coronary Calcium score of 1-400. Most patients (184) underwent CT coronary angiogram with 39 (21%) having normal coronary arteries, 126 (68%) with mild to moderate coronary artery disease and 19 (11%) with severe coronary artery disease. Subsequent assessments with invasive coronary angiography, myocardial perfusion scan and Treadmill exercise did not reveal significant disease warranting coronary revascularization. Patients with normal or mild -moderate CAD on CTCA 24 (15%) represented with acute chest pain (only one needed PCI) and 6 (3.5%) were referred to outpatient clinics over 2 years follow up. In patients with severe CAD on CTCA, 6 (32%) presented with acute chest pain and 4 (21%) needed PCI. Almost all patients were treated with statins and antiplatelets following CTCA results. Conclusion CT coronary angiography is sensitive and specific in assessment of hemodynamically significant coronary artery disease in non-diabetic patients presenting with angina in outpatient setting. CTCA in patients with normal or mild to moderate CAD also gives confidence to the clinician and prevents further un-necessary investigation and hospital admissions/outpatient referrals.

Association of Haemoglobin A1c Level with the Severity of Coronary Artery Disease in Non-diabetic Patients with Non-STSegment Elevation Myocardial Infarction

Background: In nondiabetic patients with non-STsegment– elevation myocardial infarction, hyperglycemia may be associated with adverse outcome. Objective: To find out the association between HbA1c levels and the severity of coronary artery disease in non-diabetic patients with non-ST-segment elevation myocardial infarction
 Methods: This cross sectional analytical study was carried out at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, during the period from July, 2012 to May, 2013. This study was done with an aim to find out the association between the HbA1c level and the angiographic severity of coronary artery disease in patients with non-ST- elevation myocardial infarction without diabetes mellitus. A total of 170 patients with NSTEMI without diabetes mellitus who agreed to undergo coronary angiography were included in the study. Eighty five patients were selected having HbA1c <5.7% (Group I) and 85 patients were selected having HbA1c ranging from 5.7% to 6.4% (Group II). Severity of the Coronary Artery Disease (CAD) was assessed by angiographic vessel score, and Gensini score.
 Results: The mean age of the studied patients was 51.0±9.0 years ranging from 30 to 80 years and male to female ratio was 4.5:1. The incidence of hypertension and level of RBS were significantly higher in group II than group I. The HbA1c level increased in accordance with the vessel score increment. There was a significant difference of the mean value of HbA1c among the vessel involvement groups. In this study mild CAD (scored”36) was significantly higher in group I and moderate to severe CAD (score>36) was significantly higher in group II according to Gensini score. This study showed a positive correlation between HbA1c and vessel score (r=0.47, p=0.01) and also between HbA1c and Gensini score (r=0.41, p=0.01).
 Conclusion: Elevated HbA1c levels in non-diabetic non- ST- elevation myocardial infarction patients are associated with the severity of coronary artery disease.
 Bangladesh Heart Journal 2020; 35(2) : 134-139

Identification of Four Potential Biomarkers Associated With Coronary Artery Disease in Non-diabetic Patients by Gene Co-expression Network Analysis.

BackgroundCoronary artery disease (CAD) is a type of cardiovascular disease that greatly hurts the health of human beings. Diabetic status is one of the largest clinical factors affecting CAD-associated gene expression changes. Most of the studies focus on diabetic patients, whereas few have been done for non-diabetic patients. Since the pathophysiological processes may vary among these patients, we cannot simply follow the standard based on the data from diabetic patients. Therefore, the prognostic and predictive diagnostic biomarkers for CAD in non-diabetic patient need to be fully recognized.Materials and MethodsTo screen out candidate genes associated with CAD in non-diabetic patients, weighted gene co-expression network analysis (WGCNA) was constructed to conduct an analysis of microarray expression profiling in patients with CAD. First, the microarray data GSE20680 and GSE20681 were downloaded from NCBI. We constructed co-expression modules via WGCNA after excluding the diabetic patients. As a result, 18 co-expression modules were screened out, including 1,225 differentially expressed genes (DEGs) that were obtained from 152 patients (luminal stenosis ≥50% in at least one major vessel) and 170 patients (stenosis of <50%). Subsequently, a Pearson’s correlation analysis was conducted between the modules and clinical traits. Then, a functional enrichment analysis was conducted, and we used gene network analysis to reveal hub genes. Last, we validated the hub genes with peripheral blood samples in an independent patient cohort using RT-qPCR.ResultsThe results showed that the midnight blue module and the yellow module played vital roles in the pathogenesis of CAD in non-diabetic patients. Additionally, CD40, F11R, TNRC18, and calcium/calmodulin-dependent protein kinase type II gamma (CAMK2G) were screened out and validated using enzyme-linked immunosorbent assay (ELISA) in an independent patient cohort and immunohistochemical (IHC) staining in an atherosclerosis mouse model.ConclusionOur findings demonstrate that hub genes, CD40, F11R, TNRC18, and CAMK2G, are surrogate diagnostic biomarkers and/or therapeutic targets for CAD in non-diabetic patients and require deeper validation.

The Association between Hemoglobin A1c and the Severity of Coronary Artery Disease in Non-diabetic Patients with Acute Coronary Syndrome.

IntroductionThe relationship between the severity of coronary artery disease (CAD) with hemoglobin A1c (HbA1c) levels in diabetic patients is well-understood. However, the association between HbA1c and the severity of CAD in non-diabetics is still controversial. We wanted to find out if HbA1c of the non-diabetic adult population, presenting with an acute coronary syndrome (ACS), had any correlation with the severity of CAD.MethodsWe selected 119 non-diabetic adults who underwent coronary intervention for clinical reasons during the period of July 2015 to February 2017. The mean age of the patients was 54 ± 10.2 years. All patients were labeled as ‘acute coronary syndrome’, which included unstable angina, non-ST elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). We obtained blood samples of patients for laboratory investigations, including HbA1c. We used the SYNTAX score as a tool to classify the severity of CAD, and patients having a SYNTAX score of >22 were considered to be having severe CAD.ResultsIn order to find out the association between HbA1c and CAD, a linear regression analysis of HbA1c with the SYNTAX score was performed, which showed no statistically significant correlation between the SYNTAX score and HbA1c (correlation co-efficient = 0.142; p-value = 0.124). To compare the median value of HbA1c in groups with SYNTAX scores of ≤22 and those with SYNTAX scores of >22, we analyzed the data with the Mann-Whitney U test, which showed no significant difference in HbA1c between the two groups (p-value = 0.771). We determined the independent predictors of the severity of CAD by analyzing all variables with logistic regression, considering a SYNTAX score of >22 as a dependent variable. None of the variables, including HbA1c, proved to be statistically significant in multivariate logistic regression analysis. The unadjusted and adjusted odds ratio (OR) of HbA1c with 95% confidence intervals (CI) were 1.71 (0.47-2.92), p-value = 0.735 and 0.87 (0.33-2.29), and 0.78, respectively.ConclusionIn conclusion, we find that HbA1c is not an independent predictor of the severity of CAD in non-diabetic adult patients.

Glycated Hemoglobin Level as a predictor of Severity of Coronary Artery Disease in Non-Diabetic Patients

An elevated level of glycated hemoglobin (HbA1c) has been shown to be associated with increased risk of cardiovascular outcomes and all-cause mortality in patients without Type 2 Diabetes Mellitus (T2DM).

The relation of brachial fractional flow dilatation and coronary artery disease in nondiabetic patients with or without insulin resistance

Background: Endothelial dysfunction is the early sign of cardiovascular diseases and assessed by the flow-mediated dilatation (FMD) of the brachial artery. In patients with insulin resistance, endothelial dysfunction is reduced and assessed by FMD. The work aimed to study the association between (homeostatic model assessment of the insulin resistance) and the brachial fractional flow dilatation (FFD) with the presence of coronary artery disease (CAD) in nondiabetic individuals, with or without insulin resistance. Patients and Methods: A total of 100 nondiabetic individuals were following up in the cardiology department and divided into (Group 1) 40 patients with insulin resistance (Group 2). Sixty patients without insulin resistance. FMD of the brachial artery was measured then the nitroglycerin-mediated dilatation (NMD). We calculated the fractional flow dilatation (FFD) as follow: NMD-FMD/NMD. Results: The predictive value of FFD for the detection of CAD in insulin resistance group with a cutoff value >0.465 (P < 0.0001), with a sensitivity of 89.2% and specificity of 92.3%. The predictive value of FFD is ≥0.575 (P = 0.001), with a sensitivity of 78.9% and specificity of 74.2% in the non-IR group. Conclusion: FFD is independent predictors for CAD, especially in insulin resistance subjects.

Diagnostic Accuracy of a Precision Medicine Blood Test for Assessing Obstructive Coronary Artery Disease in Nondiabetic Patients with Newly-Diagnosed Heart Failure with Reduced Ejection Fraction - A Pilot Study

IntroductionIn patients with newly-diagnosed heart failure with reduced ejection fraction (HFrEF), current guidelines recommend ischemic workup to rule out the presence of coronary artery disease (CAD), as revascularization in patients with left ventricular systolic dysfunction associated with obstructive CAD is strongly associated with improved survival. This ischemic work-up is based initially on non-invasive testing and, if indicated, invasive coronary angiography (ICA). While non-invasive testing is limited by its low diagnostic yield, ICA exposes patients to radiation, IV contrast and procedural complications. An age- and sex- specific gene expression score (ASGES) generated from precision medicine blood test has been previously validated in two large, prospective, multicenter trials to have a high sensitivity and negative predictive value in the assessment of obstructive CAD in nondiabetic patients with normal left ventricular systolic function who present with chest pain and associated symptoms who subsequently underwent ICA. Its utility for the assessment of obstructive CAD in nondiabetic patients who have symptoms arising from new-onset HFrEF has yet to be studied.HypothesisThe ASGES will have a high sensitivity and negative predictive value for predicting obstructive CAD in nondiabetic patients with newly-diagnosed HFrEF.MethodsWe enrolled 57 consecutive nondiabetic patients (median age 50.5 years, 63% males) who presented acutely to our institution with symptoms associated with new-onset HFrEF from February 2016 to February 2018. Patients underwent ICA as part of their ischemic workup before they were enrolled in our study. Whole blood samples were drawn during or within two weeks after ICA and sent to a central laboratory for generation of gene expression scores. The laboratory personnel were blinded to the patient's disease status per ICA. ASGES were then correlated with ICA results.ResultsGene expression scores were generated in 88% of patients (50 of 57 patients). The prevalence of obstructive CAD (defined as >70% stenosis in any of the major epicardial coronary arteries) was 20%. At a pre-specified cut-off of <15, the ASGES had a sensitivity, specificity, positive and negative predictive value of 90%, 50%, 31% and 95% respectively when compared to ICA in the detection of obstructive CAD.ConclusionsASGES has an excellent sensitivity and negative predictive value for predicting obstructive CAD in nondiabetic patients with newly-diagnosed HFrEF. In patients with newly-diagnosed heart failure with reduced ejection fraction (HFrEF), current guidelines recommend ischemic workup to rule out the presence of coronary artery disease (CAD), as revascularization in patients with left ventricular systolic dysfunction associated with obstructive CAD is strongly associated with improved survival. This ischemic work-up is based initially on non-invasive testing and, if indicated, invasive coronary angiography (ICA). While non-invasive testing is limited by its low diagnostic yield, ICA exposes patients to radiation, IV contrast and procedural complications. An age- and sex- specific gene expression score (ASGES) generated from precision medicine blood test has been previously validated in two large, prospective, multicenter trials to have a high sensitivity and negative predictive value in the assessment of obstructive CAD in nondiabetic patients with normal left ventricular systolic function who present with chest pain and associated symptoms who subsequently underwent ICA. Its utility for the assessment of obstructive CAD in nondiabetic patients who have symptoms arising from new-onset HFrEF has yet to be studied. The ASGES will have a high sensitivity and negative predictive value for predicting obstructive CAD in nondiabetic patients with newly-diagnosed HFrEF. We enrolled 57 consecutive nondiabetic patients (median age 50.5 years, 63% males) who presented acutely to our institution with symptoms associated with new-onset HFrEF from February 2016 to February 2018. Patients underwent ICA as part of their ischemic workup before they were enrolled in our study. Whole blood samples were drawn during or within two weeks after ICA and sent to a central laboratory for generation of gene expression scores. The laboratory personnel were blinded to the patient's disease status per ICA. ASGES were then correlated with ICA results. Gene expression scores were generated in 88% of patients (50 of 57 patients). The prevalence of obstructive CAD (defined as >70% stenosis in any of the major epicardial coronary arteries) was 20%. At a pre-specified cut-off of <15, the ASGES had a sensitivity, specificity, positive and negative predictive value of 90%, 50%, 31% and 95% respectively when compared to ICA in the detection of obstructive CAD. ASGES has an excellent sensitivity and negative predictive value for predicting obstructive CAD in nondiabetic patients with newly-diagnosed HFrEF.

Impact of Glycated Haemoglobin Level on Severity of Coronary Artery Disease in Non-Diabetic Patients

Impact of Glycated Haemoglobin Level on Severity of Coronary Artery Disease in Non-Diabetic Patients

Insulin resistance and coronary artery disease in non-diabetic patients: Is there any correlation?

Background:Cardiovascular diseases are the most common causes of death in the world and type 2 diabetes is one of them because it is highly prevalent and doubles heart disease risk. Some studies suggest that insulin resistance is associated with coronary artery disease in non-diabetics. The aim of this study was to evaluate the association of insulin resistance (IR) and coronary artery disease (CAD) in non-diabetic patients.Methods:In this cross-sectional study, from September 2014 to July 2015, 120 patients referring to Shahid Beheshti Hospital of Qom were evaluated. Their medical history, baseline laboratory studies, BMI and GFR were recorded. After 8 hours of fasting, blood samples were taken from the patients at 8 am, including fasting glucose and insulin level. We estimated insulin resistance using the homeostatic model assessment index of IR (HOMA-IR). Finally, we evaluated the association between IR and CAD.Results:Totally, 120 patients were assigned to participate in this study, among them, 50 patients without CAD and 70 with coronary artery stenosis. Insulin resistance (HOMA-IR> 2.5) was positive in 59 (49.3%) patients and negative in 61 (50.7%) patients. Hence, the correlation between IR and CAD was not statistically significant (P=0.9).Conclusions:In this study, although the correlation was not found between insulin resistance and coronary heart disease, among men, we found a significant association between coronary heart disease and insulin resistance.

The Relation between Glycated Hemoglobin and Severity of Coronary Artery Disease in Non-Diabetic Patients with Acute Coronary Syndrome

The Relation between Glycated Hemoglobin and Severity of Coronary Artery Disease in Non-Diabetic Patients with Acute Coronary Syndrome

The Relation between Glycated Hemoglobin and Severity of Coronary Artery Disease in Non-Diabetic Patients with acute coronary syndrome.

Aim: This study aimed to assess the relationship between HbA1c level and coronary artery disease (CAD) among non-diabetic patients. Methods: One hundred patients with acute coronary syndrome (ACS) who referred to coronary angiography were included. According to American Diabetes Association (ADA7) patients were classified into high risk group (HbA1c 5.7 – 6.4%) or low risk group (HbA1c <5.7%). The severity of CAD was assessed by Gensini score which allocates a numerical value for the degree of coronary stenosis and a multiplication factor that depends on lesion location. Results: The level of HbA1c was positively correlated with Gnsini score (r=0.35, P 05) or LVEF (r= -0.04, p>0.05). Conclusion: Among non-diabetic patients, higher HbA1c is significantly correlated with the severity of CAD. HbA1c level has a prognostic value to predict the severity of CAD among non-diabetic patients.

Impact of Glycated Hemoglobin Level on Severity of Coronary Artery Disease in Non-Diabetic Patients

Background: Glycated hemoglobin values reflect two to three months average endogenous exposure to glucose including postprandial spikes in blood glucose level and have low intra-individual variability particularly in non-diabetic patients. Elevated hemoglobin A1C is regarded as an independent risk factor for CAD in patients with or without DM. The purpose of this study is to determine the correlation between the level of Glycated hemoglobin (HbA1c), and the severity of coronary artery disease in non-diabetic patients. Study design and methods: The study included four hundred and eight patients referred to coronary angiography in two tertiary centers. All patients were subjected to complete medical history, physical examination and full labs including HbA1c. Transthoracic echocardiogram and coronary angiography were done and the Gensini score was calculated. Normally distributed continuous variables will be represented as mean ± SD, or as the percentage of the sample. Comparison between high and low risk groups was done using two-tailed unpaired student t test for continuous variables and the Pearson’s chi-square test for categorical variables. Results: two hundred and ninety two patients (71.6%) high risk group and 28.4% were low risk group. High risk group had HbA1c (HbA1c 5.7 – 6.4%) mg% with mean HbA1c of 6.1 ± 0.3. The mean Gensini score was 39.9 ± 34.9. The level of HbA1c was positively correlated with Gensini score (r=0.243, P<0.05,) and RWMSI (r=0.103, p=0.038) and negatively correlated with LVEF(r= -0.146, p=0.003).

Haemoglobin A1c as a marker predicting extent and severity of coronary artery disease in non-diabetic patients

Objective Lowering haemoglobin A1c (HbA1c) was shown to be associated with reduction of microvascular, neuropathic and possibly macrovascular complications in diabetic patients. However, in non-diabetic patients, few reports have examined the relation between HbA1c and extent of coronary artery disease. The aim of this study was to examine the relationship between HbA1c level and severity of coronary artery disease (CAD) in non-diabetic patients scheduled for elective coronary angiography.Methods We prospectively studied 408 consecutive non-diabetic patients with or without history of previous myocardial infarction who were scheduled for conventional coronary angiography. HbA1c was measured in all patients at the time of admission. Severity of CAD was assessed by the Gensini score. Gensini score > 30 was considered severe coronary atherosclerosis. Patients were divided into two groups: the high-risk group (HbA1c, 5.7-6.4%) and the low-risk group (HbA1c, < 5.7%).Results Patients in the high-risk group had a higher Gensini score (45.1 ± 36.7 vs 26.8 ± 26.0, P< 0.001). Patients with a Gensini score > 30 had higher values of HbA1c (6.0 ± 0.48 vs 5.75 ± 0.54, P< 0.001). HbA1c showed a positive correlation with the Gensini score. HbA1c value of 5.85% showed a sensitivity and specificity of 70 and 50%, respectively, for prediction of severe coronary atherosclerosis.Conclusion HbA1c is significantly associated with severe coronary atherosclerosis in non-diabetic patients.

Glycated Hemoglobin (HbA1c) Correlation with Severity of Coronary Artery Disease in Non-diabetic Patients - A Hospital based Study from North-Eastern India.

Glycated Hemoglobin (HbA1c) levels are predictive of cardiovascular disease and mortality in patients with diabetes mellitus, however, association of HbA1c with Coronary Artery Disease (CAD) in non-diabetics is inconsistent. To evaluate the correlation between HbA1c level and severity of CAD in non-diabetic patients using SYNTAX score in a cohort of proven CAD on angiography at Gauhati Medical College, Guwahati, Assam, India, which is a major tertiary care hospital of North-Eastern India. We prospectively collected data of non-diabetic patients with proven CAD on angiography from June 2014 to June 2015. Patients were divided into four groups (interquartiles) according to HbA1c levels, less than 4.8%, 4.8% to 5.1%, 5.1% to 5.6%, and 5.6% to 6.5%. Severity of CAD was assessed using SYNTAX score and the number of coronary vessels diseased. We compared different quartiles of HbA1c with regard to SYNTAX score and number of diseased vessels. A total of 346 patients were included in the study. Mean age was 58.1±10.4 years. Of the total 91.9% (318) were males, 44.8% (155) were hypertensives, 29.2% (101) were smokers and 34.7% (120) were dyslipidemic. We found that CAD severity by SYNTAX score as well as number of vessels involved was significantly different among quartiles (p-values <0.001 and <0.001 respectively). Increase in HbA1c level was strongly correlated with disease severity and higher SYNTAX score. A significant increase was noted in the mean number of diseased vessels (p-value <0.001) as HbA1c level increases. Age, gender, hypertension and dyslipidemia did not show significant difference among quartiles however smoking was found to be an independent predictor of severity of CAD by SYNTAX score (p <0.05). From this clinical study, we can conclude that a significant correlation exists between HbA1c and severity of CAD by SYNTAX score as well as number of vessels involved in non- diabetes.

Leveraging next-generation phenotyping and pan-omics to identify novel biomarkers and pharmaceutical targets for cardiovascular disease.

Leveraging next-generation phenotyping and pan-omics to identify novel biomarkers and pharmaceutical targets for cardiovascular disease.