Study of Coronary Artery Disease Severity with HbA1c in Patients with Diabetes Mellitus with SYNTAX Score II -A Prospective Observational Study

Background and Aim: Coronary artery disease (CAD) is a major contributor to mortality in those with diabetes.Chronic hyperglycaemia exacerbates endothelial dysfunction, vascular inflammation, and atherosclerosis, hence worsening the severity of CAD.The SYNTAX score II (SSII) is a common tool for assessing the complexity of CAD and guiding treatment decisions.This study seeks to evaluate the severity of CAD in diabetic patients using the SSII and examining the association between glycated hemoglobin (HbA1c) and additional risk factors.Materials and Methods: An observational study was conducted at SRM Medical College Hospital and Research Centre, enrolling 121 diabetic patients with angiographically confirmed CAD.SSII was applied to classify patients into low (<22), intermediate (23-32), and high (33) risk categories.Logistic regression and chi-square tests were employed to assess the associations between HbA1c levels, duration of diabetes, and severity of CAD. Results:The average HbA1c was 8.53%1.68,and the diabetes duration was 7.174.64years.Higher HbA1c levels were significantly associated with severe CAD (P = 0.040), with each 1% increase in HbA1c raising the odds of high-risk SSII by 62.9% [odds ratio (OR) =1.62, P = 0.014].Prolonged diabetes duration (OR =1.13, P = 0.049) and reduced left ventricular ejection fraction (OR =0.0004, P = 0.019) were also independent predictors. Conclusion:Elevated HbA1c levels and prolonged diabetes duration are strongly associated with CAD severity in diabetic patients.SSII functions as a valuable instrument for risk stratification and the formulation of treatment plans.