The Relation between Carotid Intimal Medial Thickness and HbA1c with The Severity of Coronary Artery Disease in Diabetic Patients

Background: Research has demonstrated a link between glycated hemoglobin (HbA1c) levels and coronary artery disease (CAD). The HbA1c level can serve as a prognostic indicator for both the severity of CA in diabetic patients and the likelihood of future cardiovascular events. The severity of carotid artery disease can be assessed using Carotid Intima Medial Thickness (CIMT). Objectives: This study aimed to examine the relationship between CIMT, HbA1c levels, and the severity of CAD in diabetic patients. Patients and methods: Our prospective comparative study was carried out on 160 diabetic patients diagnosed with ischemic heart disease. They were recruited from Cardiology Department in Menoufia University Hospital during the period from September 2019 to March 2021. Full history taking, clinical examination, laboratory investigations, Conventional Echocardiography, Carotid ultrasonography, Coronary angiography and Gensini score were studied. Results: CIMT was significantly higher in patients with high Gensini score than other groups (p < 0.05). Regarding lipid profile, total cholesterol and LDL levels were significantly higher in patients with high Gensini score than in other groups (p < 0.05). Similarly, HbA1c was significantly higher in patients with high Gensini score than in other groups (p < 0.05). HbA1c and CIMT cut values (9.92 and 1.5 respectively) predicted high Gensini score with sensitivity of 71.8% & 80.2% respectively and specificity of 68.01, 70.91 respectively. Conclusion: A significant positive association between CIMT and HbA1C was detected in diabetic patients and both were notably increased in diabetic patients with severe CAD measured with the Gensini score.