RELATIONSHIP OF GLYCATED HEMOGLOBIN WITH SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Objective: To determine the association between HbA1c levels and angiographicseverity of CAD in patients with NSTEMI.

Methodology: This cross-sectional study was conducted in Lady ReadingHospital, Peshawar from 3rd March, 2016 to 23rd July, 2016. All patients withhistory of typical chest pain of cardiac origin and positive hs-Trop T valuepresenting to cardiology unit with non ST elevation MI on ECG who underwentangiography were included in the study. A complete history, physicalexamination, lab investigations and ECG with echocardiography were done tofulfill the inclusion and exclusion criteria. HbA1c levels were determined for allpatients and were categorized into 5 groups. All patients underwent coronaryangiography and were categorized into 4 groups, i.e., none, mild, moderate andsevere CAD. Association between HbA1c levels and CAD was determined byusing Chi-Square test.

Results: A total of 100 patients were included with a mean age of 56.04±9.24years. Of these, 70% were males and 68% were diagnosed diabetics. MeanHbA1c 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 diabeticrange 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. Byusing Chi- Square test, association between HbA1c and CAD was calculated tobe 141.96 (p ≤0.001). Increased levels of HbA1c also increased the PORs ofCAD by 2.44 times (p≤0.001).

Conclusion: HbA1c is strongly associated with severity of CAD. It proved to be anindependent risk factor for CAD and had a prognostic significance in predictingseverity of CAD.

Key Words: HbA1c, Coronary Artery Disease, NSTEMI.