IMPACT OF GLYCATED HEMOGLOBIN LEVEL ON CLINICAL AND ANGIOGRAPHIC DATA IN NON-DIABETIC PATIENTS PRESENTING WITH NON- ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

Abstract

SUMMARY G lycated hemoglobin (HbA1c) values reflect two to three months average exposure to glucose including postprandial spikes in blood glucose level and have low intra-individual variability particularly in non-diabetic patients. Some studies suggest that HbA1c values in the normal range can identify persons at increased risk for CAD, stroke, and death before the diagnosis of diabetes, indicating that HbA1c is a useful marker of cardiovascular risk and death. In our study, we tried to demonstrate the impact of HbA1c level on the clinical and angiographic data of 100 non-diabetic patients presenting with non – ST elevation myocardial infarction by studying the correlation between HbA1c and NSTEMI in those patients undergoing coronary angiography and intervention as indicated clinically and assessment the severity of CAD by the Gensini score and SYNTAX score from the anatomical aspect and by the Grace2 score from the clinical aspect. In our study, we classified the population according to the level of HbA1c into two groups; normal group (HbA1c ≤5.6 %) and predaibetic group (HbA1c 5.7% – 6.4%) according to ADA classifications154. In predaibetic patients (HbA1c=5.7 - 6.4%) presenting with NSTEMI, Gensini score (representing the anatomical severity) and Grace score (representing the clinical risk) were significantly higher than in patients with normal HbA1c (≤5.6%), whereas the SYNTAX score (representing the anatomical complexity) showed no statistic difference between the two groups. There was a significant positive correlation between HbA1c and Gensini score, GRACE score, age and dyslipidemia of the patients, but no correlation regarding the SYNTAX score. There was a significant negative correlation between HbA1c and systolic blood pressure post NSTEMI.