Association of HbA1c Levels with Complexity of Coronary Artery Disease in Diabetic Patients Presenting with Acute Coronary Syndrome
Keywords:
Glycated hemoglobin, Coronary artery disease, Acute coronary syndromeAbstract
Objective: To determine the association of Hemoglobin A1c (HbA1c) levels with the complexity of coronary artery disease (CAD) in diabetic patients presenting with acute coronary syndrome (ACS), in terms of higher synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score measured during coronary angiography.
Methodology: This cross-sectional comparative study was conducted at Fauji Foundation Hospital, Rawalpindi from July to September 2025 after approval from the ethical committee of the institution. Patients were divided into two groups. Those with HbA1c ≤7% were labeled as group 1 and group 2 had patients with HbA1c >7%. After informed written consent, 122 confirmed diabetic patients who presented with ACS and underwent coronary angiography were included using non-probability convenience sampling. The SYNTAX score was estimated to determine angiographic disease complexity. The patients with scores of 0-22 were labeled as low risk, 23-32 as intermediate, and >32 as high-risk CAD. The blood samples of patients were taken and sent for HbA1c levels and fasting lipid profile. Data analysis was carried out with the Statistical Package for the Social Sciences (SPSS) version 26.
Results: When CAD risk categories were compared with HbA1c groups, the majority of the patients in group 1 (34.4%) and group 2 (24.6%) had low risk and intermediate risk CAD, respectively. There was a significant and moderate positive correlation (r=0.528) between HbA1c and SYNTAX scores (p-value=0.001). Only the lipid profile showed a significant relationship with CAD risk categories.
Conclusion: The majority of patients with HbA1c ≤7% had low-risk CAD, while patients with HbA1c >7% had intermediate-risk CAD. The SYNTAX score significantly increased with increasing HbA1c levels. In addition, the patients with intermediate and high-risk CAD also had dyslipidemia.
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