Abstract
Objective: To determine the association between HbA1c levels and angiographic severity of CAD in patients with NSTEMI.
Methodology: This cross-sectional study was conducted in Lady Reading Hospital, Peshawar from 3rd March, 2016 to 23rd July, 2016. All patients with history of typical chest pain of cardiac origin and positive hs-Trop T value presenting to cardiology unit with non ST elevation MI on ECG who underwent angiography were included in the study. A complete history, physical examination, lab investigations and ECG with echocardiography were done to fulfill the inclusion and exclusion criteria. HbA1c levels were determined for all patients and were categorized into 5 groups. All patients underwent coronary angiography and were categorized into 4 groups, i.e., none, mild, moderate and severe CAD. Association between HbA1c levels and CAD was determined by using Chi-Square test.
Results: A total of 100 patients were included with a mean age of 56.04 +/- 9.24 years. Of these, 70% were males and 68% were diagnosed diabetics. Mean HbA1c level was 7.0 +/- 1.3% with 61% patients having higher HbA1c levels, 21% patients had HbA1c in normal range, 18% in pre-diabetic range, 17% in diabetic range with good control, 31% in diabetic range with satisfactory control and 13% in diabetic range with poor control. About 27% patients had no CAD while mild, moderate and severe CAD was present in 31%, 28% and 14% respectively. By using Chi-Square test, association between HbA1c and CAD was calculated to be 141.96 (p <= 0.001). Increased levels of HbA1c also increased the PORs of CAD by 2.44 times (p <= 0.001).
Conclusion: HbA1c is strongly associated with severity of CAD. It proved to be an independent risk factor for CAD and had a prognostic significance in predicting severity of CAD.