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Association between mean HbA1c, HbA1c variability, and severity of coronary artery disease using SYNTAX score in
Abbas Andishmand1, Mohamad Montazeri1, Hamed Bahrami1
1Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Insights
Higher average blood sugar (mean-HbA1c) is linked to more severe coronary artery disease (CAD) in type 2 diabetes patients. Glycemic variability did not significantly impact CAD severity in this study.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Diseases
Background:
- Coronary artery disease (CAD) is a major complication for individuals with type 2 diabetes mellitus (T2DM).
- The impact of long-term glycemic variability (GV) on CAD severity in T2DM patients is not well understood.
- This study investigates the association between long-term GV and the extent of CAD in T2DM.
Purpose of the Study:
- To determine if long-term glycemic variability (GV) influences the severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM).
- To assess the relationship between mean HbA1c, glycemic variability (SD-HbA1c, CV-HbA1c), and coronary lesion severity (SYNTAX score).
Main Methods:
- Retrospective cohort study of 115 T2DM patients undergoing coronary angiography.
- Glycemic variability assessed using standard deviation (SD) and coefficient of variation (CV) of HbA1c.
- Coronary artery lesion severity quantified by the SYNTAX scoring system.
- Linear regression analyses used to evaluate associations between glycemic measures and SYNTAX scores.
Main Results:
- Patients with mean HbA1c > 7.5 exhibited significantly higher SYNTAX scores (12.79) compared to those with mean HbA1c ≤ 7.5 (7.33).
- No significant correlation was found between SD-HbA1c, CV-HbA1c, and SYNTAX scores in univariate or multivariate analyses.
- A mean HbA1c cutoff of 7.5 was identified via ROC curve analysis.
Conclusions:
- Elevated mean HbA1c levels are associated with increased coronary artery disease severity in T2DM patients.
- Long-term glycemic variability, measured by SD-HbA1c and CV-HbA1c, does not appear to significantly impact CAD severity.
- Clinical focus on managing average blood glucose levels may be crucial for mitigating CAD risk in T2DM.
Background:
Coronary artery disease (CAD) is a significant complication of type 2 diabetes mellitus (T2DM). The relationship between long-term glycemic variability (GV) and CAD severity remains uncertain. This study aimed to investigate the association between long-term GV and the extent of CAD in individuals with T2DM.
Materials And Methods:
This retrospective cohort study included patients with T2DM who underwent coronary angiography. Mean-HbA1c was calculated for each patient. GV was assessed by measuring the standard deviation (SD) and coefficient of variation (CV) of HbA1c measurements. The severity of coronary artery lesions was evaluated using the SYNTAX scoring system. Linear regression analyses were performed to assess the differences in SYNTAX scores among different mean-HbA1c groups, as well as SD-HbA1c and CV-HbA1c quartiles.
Results:
A total of 115 diabetic patients were included in the study. The mean-HbA1c cutoff value of 7.5 was derived from the receiver-operating characteristic curve. Fifty-six patients had a mean-HbA1c of 7.5 or lower, whereas 59 patients had a mean-HbA1c above 7.5. Univariate analysis revealed that patients with mean-HbA1c above 7.5 had significantly higher SYNTAX scores compared to those with lower mean-HbA1c levels (12.79 vs. 7.33, P < 0.05). There was no significant correlation observed between SD-HbA1c, CV-HbA1c, and SYNTAX scores in both univariate and multivariate analyses.
Conclusion:
This study suggests that higher mean-HbA1c levels are associated with increased severity of CAD in individuals with T2DM. However, long-term HbA1c variability, as measured by SD-HbA1c and CV-HbA1c, does not appear to have a significant impact on the severity of CAD.
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