CORRELATION BETWEEN HBA1C LEVELS AND SEVERITY OF CORONARY ARTERY DISEASE
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Keywords
HbA1c, glycated hemoglobin, coronary artery disease, coronary angiography, multivessel disease, type 2 diabetes mellitus
Abstract
Background: Chronic hyperglycemia is a risk factor for atherosclerotic progression, and coronary artery disease (CAD) is a major cause of morbidity and mortality in the world. One easy-to-obtain marker that could be used to assess coronary atherosclerotic burden is glycated hemoglobin (HbA1c).
Objective: To assess the relationship between HbA1c and the severity of coronary artery disease by angiography.
Methods: The study was cross-sectional analytical and was conducted at Hameed Latif Hospital, Lahore, from January, 2025 to June, 2025. Patients were recruited consecutively to the study for coronary angiography for suspected or established CAD (n = 200). HbA1C was determined by a standardized laboratory method, and the severity of the disease was determined by the number of diseased vessels. One-way ANOVA, correlation analysis, and receiver operating characteristic analysis (ROC) were used to assess the associations.
Results: The mean age was 57.8 ± 10.6 years, and 62.0% of patients were male. The mean HbA1c was significantly higher (p < 0.001) in patients with significant CAD (7.9 ± 1.3%) than in those without significant CAD (6.1 ± 0.7%). The number of diseased vessels was positively correlated with HbA1c (ρ = 0.50, p < 0.001). Multivessel disease was found in 72.0% of patients with HbA1c ≥ 7.0% and 36.0% of patients with HbA1c < 7.0% (p < 0.001). The AUC for HbA1c was fair for the discrimination of multivessel disease (0.74).
Conclusion: An elevated HbA1c is highly correlated with angiographic severity of CAD and could be used to help cardiovascular risk stratification, but it is not a substitute for angiography. Larger multicenter studies are recommended.
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