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. 2014 May 29:13:89.
doi: 10.1186/1476-511X-13-89.

Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina

Li-Feng Hong, Xiao-Lin Li, Yuan-Lin Guo, Song-Hui Luo, Cheng-Gang Zhu, Ping Qing, Rui-Xia Xu, Na-Qiong Wu, Jian-Jun Li  1
Affiliations

Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina

Li-Feng Hong et al. Lipids Health Dis. .

Abstract

Background: Glycosylated hemoglobin A1C (HbA1c) has been widely recognized as a marker for predicting the severity of diabetes mellitus (DM) and several cardiovascular diseases. However, whether HbA1c could predict the severity and clinical outcomes in patients with stable coronary artery disease (CAD) remains largely unknown. We determine relationship of HbA1c with severity and outcome in patients with stable CAD.

Methods: We enrolled 1433 patients with stable angina who underwent coronary angiography and were followed up for an average 12 months. The patients were classified into three groups by tertiles of baseline HbA1c level (low group <5.7%, n = 483; intermediate group 5.7 - 6.3%, n = 512; high group >6.3%, n = 438). The relationships between the plasma HbA1c and severity of CAD and early clinical outcomes were evaluated.

Results: High HbA1c was associated with three-vessel disease. Area under the receivers operating characteristic curve (AUC = 0.67, 95% CI: 0.63-0.71, P < 0.001) and multivariate logistic regression analysis suggested that HbA1C was an independent predictor of severity of CAD (OR = 1.60, 95% CI: 1.29-1.99, P < 0.001) even after adjusting for gender, age, risk factor of CAD, lipid profile and fasting blood glucose. During follow-up, 133 patients underwent pre-specified outcomes. After adjusting for multiple variables in the Cox regression model, HbA1C remained to be an independent predictor of poor prognosis (HR = 1.28, 95% CI: 1.12-1.45, P < 0.001).

Conclusions: We concluded that high level of baseline HbA1c appeared to be an independent predictor for the severity of CAD and poor outcome in patients with stable CAD.

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Figures

Figure 1
Figure 1
Distribution of baseline serum hemoglobin A1C level in the study population.
Figure 2
Figure 2
Association of tertiles of serum hemoglobin A1C levels and extent of coronary artery disease.
Figure 3
Figure 3
ROC curves showed discriminatory power of serum hemoglobin A1C levels on coronary artery disease.
Figure 4
Figure 4
Association of tertiles of serum hemoglobin A1C levels and 12-month outcome.
Figure 5
Figure 5
Kaplan-Meier curve for cumulative event-free survival based on tertiles of baseline plasma hemoglobin A1c levels.
See this image and copyright information in PMC

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