EVALUATION OF THE RELATIONSHIP BETWEEN SERUM HBA1C LEVEL AND SEVERITY OF CAD IN DIABETIC PATIENTS

Glycated hemoglobin (HbA1c) is a form of hemoglobin that is measured primarily
to identify the average plasma glucose concentration over prolonged periods of time. In diabetes
mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels,
have been associated with cardiovascular disease, nephropathy, and retinopathy. Monitoring HbA1c in
type 1 diabetic patients may improve outcomes. This study aimed to evaluate the relationship between
serum HbA1C level and severity of coronary artery disease (CAD) in diabetic patients at Urmia
Taleghani Hospital by selective coronary angiography.
Materials & Methods: This descriptive and solidarity research was performed on 188 diabetic patients
candidate for selective coronary angiography (SCA) in Urmia Taleghani Hospital according to
purposive and including criteria. These patients were divided into 3 groups on the base of serum HbA1C
level (HbA1C<7%, HbA1C between 7-9% and HbA1C>9%). Also the patients were divided into 4
groups on the base of SCA findings: no CAD, one vessel disease (1VD), 2 vessel disease (2VD), and 3
vessel disease (3VD). Samples were analyzed by SPSS-16.
Results: There were 86(45.7%) male and 102(54.3%) female. The mean age of patients was 58.63+/-
9.66 years. Coronary angiography revealed 1VD in 59 patients (31.4%), 2VD in 43 patients (22.9%),
3VD in 51 patients (27.1%) and normal coronary arteries in 35 patients (18.6%). Results of study
showed HbA1C>9% in 73 patients (38.8%), HbA1C=7-9% in 96 patients (51%) and HbA1C<7% in 19
patients (10.2%). There was significant statistical relationship between serum HbA1C level and severity
of CAD (P=0.002). Also there was significant relationship between CAD and positive family history
(P=0.03). Analyses were performed independently in males and females and there was no relationship
between smoking and severity of CAD on the base of gender consideration (P-value in male=0.160 and
P-value in female=0.281).
Conclusion: The findings of our study revealed significant relationship between serum HbA1C level
and severity of CAD in diabetic patients. HbA1C can estimate severity of CAD. Accordingly with tight
controlled diabetic mellitus, we can reduce number of severe CAD.