RAMAZAN GÜVEN1, GÜZIN AYKAL2, FARUK GÜNGÖR3, K. CAN AKYOL3, NERMIN BAYAR4
1Department of Emergency Medicine, Bitlis State Hospital, Bitlis, Turkey - 2Department of Biochemistry, Antalya Training And Research Hospital, Antalya, Turkey - 3Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey - 4Department of Cardiology, Antalya Training And Research Hospital, Antalya, Turkey
Introduction: Diabetes mellitus (DM) has long been recognized as a major risk factor for coronary artery diseases (CAD). Although Hemoglobin A1c (HbA1c) has been widely used as a marker for predicting the severity of DM, there are controversial reports in the literature regarding its association with the severity of CAD. The aim of our study was to determine the association between HbA1c levels and severity of CAD in both diagnosed and undiagnosed diabetic patients with admission hyperglycemia.
Materials and methods: The files of the patients who were admitted to the emergency department of a regional training and research hospital from 2014 to 2015 due to acute coronary syndrome and whose diagnosis was confirmed by coronary angiography and HbA1c levels were analyzed were reviewed retrospectively. Those patients whose HbA1c levels were measured were divided into two groups: diagnosed diabetes (DD) or undiagnosed diabetes (UDD). Gensini score was measured for all patients and the correla- tion between elevated HbA1c levels and severity of coronary artery disease was subjected to statistical analysis.
Results: Out of 168 patients who met the inclusion criteria, 85.1% (n=143) were male, while 14.9% (n=25) were female. The mean age was 46.6±6.5 years. HbA1c was found to have a significantly positive correlation with the Gensini score in DD group (n=77), whereas no significant correlation was found between HbA1c and the Gensini score in UDD group (n=91) (p <0.001; correla- tion coefficient: 0.656, p=0.207; correlation coefficient: 0.251, respectively). Linear regression analysis revealed that HbA1c was a significant predictor for gensini score (p<0.001; β: 0.632).
Conclusion: HbA1c can be used as a predictor for the evaluation of diabetic patients with CAD. Moreover, HbA1c was not found to have a significant association with the severity of CAD in undiagnosed diabetic CAD patients with admission hyperglycemia.
coronary artery disease, diabetes mellitus, HbA1c, gensini score.