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Relationship Between Fasting Glucose, HbA1c Levels, and the SYNTAX Score 2 in Patients With Non-ST-Elevation

Alparslan Kilic1, Onur Baydar1

  • 1Department of Cardiology, 52979Koc University Hospital, Istanbul, Turkey.

Angiology
|May 7, 2021
PubMed

Insights

In non-diabetic patients with non-ST-elevation myocardial infarction (NSTEMI), admission glycosylated hemoglobin (HbA1c) levels showed a stronger correlation with coronary artery disease (CAD) severity than fasting glucose. This finding highlights HbA1c as a potential marker for CAD complexity in this population.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Diagnostics

Background:

  • Coronary artery disease (CAD) severity assessment is crucial for guiding treatment in patients with non-ST-elevation myocardial infarction (NSTEMI).
  • The role of glycemic markers, specifically glycosylated hemoglobin (HbA1c) and fasting glucose, in predicting CAD severity in non-diabetic NSTEMI patients requires further elucidation.
  • The anatomical SYNTAX score 2 (SSII) is a validated tool for evaluating CAD complexity.

Purpose of the Study:

  • To investigate the correlation between admission glycosylated hemoglobin (HbA1c) and fasting glucose levels with coronary artery disease (CAD) severity in non-diabetic patients experiencing non-ST-elevation myocardial infarction (NSTEMI).
  • To determine which glycemic marker, HbA1c or fasting glucose, better predicts CAD severity as assessed by the SSII.

Main Methods:

  • A retrospective analysis was conducted on 359 non-diabetic patients hospitalized with NSTEMI who underwent coronary angiography.
  • Coronary artery disease severity was quantified using the SYNTAX Score 2 (SSII).
  • Patients were stratified into tertiles based on SSII scores (low, mid, high), and correlations with admission HbA1c and fasting glucose levels were analyzed.

Main Results:

  • A significantly stronger correlation was observed between HbA1c levels and SSII (r = 0.901, P < .001) compared to fasting glucose and SSII (r = 0.378, P < .001).
  • Higher HbA1c levels and a history of hypertension were identified as independent risk factors for high SSII scores (OR: 2.2 and 1.1, respectively).
  • The average patient age was 57.1 ± 10.9 years, with 52.1% males.

Conclusions:

  • Admission HbA1c levels are a more robust indicator of coronary artery disease severity in non-diabetic NSTEMI patients than fasting glucose levels.
  • HbA1c may serve as a valuable predictive marker for complex CAD in this specific patient cohort.
  • These findings underscore the importance of evaluating glycemic control, even in non-diabetic individuals, for comprehensive risk stratification in NSTEMI.

Keywords:
HbA1c levelsSYNTAX score 2fasting glucose

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