Relationship between Glycemic Control and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography
Keywords:
Glycated Haemoglobin, Hba1c, Coronary Artery Disease, Coronary Angiography, Gensini Score, Diabetes Mellitus, Glycaemic Control, Atherosclerosis.Abstract
Background: Coronary artery disease (CAD) is a major cause of cardiovascular morbidity and mortality worldwide. Diabetes mellitus and chronic hyperglycaemia contribute to accelerated atherosclerosis and increased coronary disease burden. Glycated haemoglobin (HbA1c), a marker of long-term glycaemic control, may provide useful information regarding the severity of coronary artery disease.
Aim: To evaluate the relationship between glycaemic control and the severity of coronary artery disease in patients undergoing coronary angiography.
Materials and Methods: This hospital-based observational study included 100 consecutive patients undergoing coronary angiography for evaluation of suspected or established coronary artery disease. Baseline demographic and clinical parameters were recorded, and glycaemic status was assessed by HbA1c levels. Coronary angiographic severity was evaluated using the Gensini scoring system. The association between HbA1c levels and angiographic severity of CAD was assessed using correlation analysis and multivariable logistic regression.
Results: The mean age of the study population was 56.8 ± 10.4 years, with males comprising 72% of participants. Poor glycaemic control (HbA1c ≥7%) was observed in 54% of patients. Patients with poor glycaemic control had significantly higher mean Gensini scores compared with those with HbA1c <7% (55.8 ± 26.4 vs 27.1 ± 18.7; p<0.001). Multivessel coronary artery disease was more frequent among patients with HbA1c ≥7% (79.6% vs 54.3%; p=0.009). HbA1c showed a significant positive correlation with Gensini score (r=0.62; p<0.001). On multivariable logistic regression analysis, HbA1c ≥7% was an independent predictor of severe coronary artery disease (OR 3.4, 95% CI 1.6–7.1; p=0.001).
Conclusion: Poor glycaemic control was significantly associated with increased angiographic severity of coronary artery disease. HbA1c may serve as a simple and valuable marker for identifying patients at higher risk of severe coronary atherosclerotic burden and may assist in cardiovascular risk stratification.
