The Association of HbA1c with Severity of Coronary Artery Disease in Patients Presenting as Acute Coronary Syndrome

Introduction: Diabetes mellitus (DM) is recognized as a critical and independent predictor of mortality in coronary artery disease (CAD). Glycated hemoglobin (HbA1c) serves as a crucial indicator for monitoring blood sugar control in diabetic individuals. Aim: This study aimed to explore how HbA1c levels correlate with the severity of coronary artery disease in patients presenting with acute coronary syndrome (ACS). Materials and Methods: We performed an observational retrospective study including 90 patients who underwent coronary angiography due to angina were enrolled. All patients gave their informed consent before taking part. Results: The study included 90 patients, with a demographic breakdown of 77% male and 23% female. Within this group, 33% were hypertensive, 50% were smokers, and 43% had dyslipidemia. Analysis of HbA1c levels revealed that 13% of participants had values in the non diabetic range, 46% were classified as pre-diabetic, and 40% were within the diabetic range (7% had HbA1c levels between 6.5-7%, 13% ranged from 7-8%, and 20% exceeded 8%). The predominant type of ACS observed was ST-elevation myocardial infarction, present in 70% of cases, followed by NSTEMI in 26% and unstable angina in 4%. Coronary angiography findings indicated single-vessel disease in 43% of patients, double-vessel disease in 33%, and triple-vessel disease in 24%. And the left anterior descending (LAD) artery was the most frequently affected seen in 90% of cases. Conclusion: Our analysis indicates that HbA1c variability plays a role for the severity of CAD in patients with T2DM. HbA1c variability may provide additional information and require management even at the glycemic target.