Diabetes Metab J.  2014 Feb;38(1):58-63. 10.4093/dmj.2014.38.1.58.

Assessment of the Association between Mean Hemoglobin A1c Levels for 5 Years and Coronary Artery Disease by Coronary Angiography in Nondiabetic Patients

• Kim JJ
• Kang JH
• Goo JJ
• Kim KN
• Lee JY
• Kim MK
• Kim TI

• KMID: 2174186
• DOI: http://doi.org/10.4093/dmj.2014.38.1.58

Abstract

BACKGROUND
The effects of glucose on cardiovascular events or mortality in nondiabetic patients has been recently reported. However, since atherosclerosis can be formed over a long period of time, it is necessary to devote several years to unveil the relationship between the two factors. Here, we attempted to find out the relationship between the mean hemoglobin A1c (HbA1c) level and HbA1c variability for 5 years and coronary artery disease (CAD) by using coronary angiography (CAG) to assess nondiabetic patients.
METHODS
We reviewed patients who performed CAG who were followed up for at least 5 years after the initial diagnosis. The fasting blood test was performed annually for glucose and HbA1c level. CAD was defined as more than 50% of luminal narrowing. The severity of CAD was divided into two groups depending on whether no vessels were involved or one more vessel were involved (CAD(-) or CAD(+), respectively).
RESULTS
The patients in CAD(+) group had higher mean HbA1c level for 5 years than CAD(-) group (5.71+/-0.40 vs. 5.86+/-0.68; P=0.04). Mean HbA1c was a significant predictor for CAD in multiple regression (odds ratio, 2.224; P=0.028). The percentage of patients with CAD was significantly higher in patients with >6.2% of mean HbA1c levels compared to patients with <6.2% of mean HbA1c levels (P<0.019).
CONCLUSION
When the mean HbA1c levels were above 6.2%, the risk of CAD was higher. Also this study shows that HbA1c level can be one of the predictors for CAD even if the patients do not have diabetes.

Keyword

Coronary artery disease; Hemoglobin A, glycosylated

MeSH Terms

Atherosclerosis
Coronary Angiography*
Coronary Artery Disease*
Coronary Vessels*
Diagnosis
Fasting
Glucose
Hematologic Tests
Hemoglobin A, Glycosylated
Humans
Mortality
Phenobarbital
Glucose
Hemoglobin A, Glycosylated
Phenobarbital

Figure

• 

  Fig. 1 The percentage of patients with coronary artery disease in groups divided by the mean hemoglobin A1c (HbA1c) levels.

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