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Relationship between Hemoglobin A1c and Fractional Flow Reserve Lesion Severity in Non-diabetic Patients
1Department of Cardiology, Silopi State Hospital, Sirnak, Turkey.
Insights
In non-diabetic patients, higher HbA1c levels correlate with more severe coronary artery disease (CAD) as indicated by fractional flow reserve (FFR). This finding suggests HbA1c may predict CAD severity in individuals without diabetes.
Area of Science:
- Cardiology
- Endocrinology
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) severity is often assessed using fractional flow reserve (FFR).
- HbA1c, a measure of long-term glycemic control, is typically used for diabetes management.
- The relationship between HbA1c and CAD severity in non-diabetic individuals is not well-established.
Purpose of the Study:
- To investigate the correlation between HbA1c levels and the severity of CAD, as determined by FFR, in patients without diabetes.
- To identify if HbA1c can serve as a predictive marker for CAD severity in this population.
Main Methods:
- An observational study was conducted involving patients undergoing elective FFR procedures.
- Patients were categorized into two groups based on FFR values: <0.8 (indicating significant stenosis) and ≥0.8.
- HbA1c levels were compared between these groups, with statistical analysis including Pearson Chi-square, Fisher's Exact test, and ROC analysis.
Main Results:
- The study included 75 patients in the FFR <0.8 group and 39 in the FFR ≥0.8 group.
- HbA1c levels were significantly higher in the FFR <0.8 group (5.8 IQR: 5.7-6.0) compared to the FFR ≥0.8 group (5.5 IQR: 5.2-6.0, p=0.002).
- Receiver operating characteristic analysis identified an HbA1c cut-off value of 5.55, with 88% sensitivity and 53.85% specificity for predicting significant CAD.
Conclusions:
- HbA1c levels are significantly associated with the severity of coronary artery disease in non-diabetic individuals.
- This suggests that HbA1c may be a useful biomarker for assessing CAD severity, even in the absence of diabetes.
- Further research is warranted to explore the clinical implications of this association.
Objective:
To find out whether there is any correlation between the fractional flow reserve (FFR) that indicates the severity of coronary artery disease (CAD), and the HbA1c value in non-diabetic patients.
Study Design:
Observational study.
Place And Duration Of Study:
Department of Cardiology, Dicle University, Turkey, from September 2015 to November 2019.
Methodology:
Patients who underwent elective FFR procedure were included in the study. There were two groups formed according to FFR lesion severity: FFR <0.8 group (75 patients), FFR >0.8 group (39 patients). HbA1c was compared between the two groups. The relationship between categorical variables was examined with Pearson Chi-square and Fisher's Exact test. ROC (Receiver operating characteristic) analysis was performed for the HbA1c the cut-off value.
Results:
The two groups were similar in terms of mean age and male gender ratios (58.4±9.6 vs. 57.9 ± 10.8 years, p=0.794; 64% vs. 74.4%, respectively, p=0.262). HbA1c value was statistically higher in the group with FFR value <0.8 [(5.8 (IQR: 5.7-6.0)] compared to the group with FFR value ≥0.8 [(5.5 (IQR: 5.2-6.0, p = 0.002)]. The HbA1c cut-off value was determined as 5.55. The ideal HbA1c threshold value calculated by the Youden index had 88% sensitivity, and 53.85% specificity.
Conclusion:
HbA1c, which shows the long-term glycemic index in non-diabetic individuals, is associated with the severity of CAD determined by the fractional flow reserve. Key Words: Coronary artery disease, fractional flow reserve, HbA1c.
