Ajudani Reza, Rezaee-Zavareh Mohammad Saeid, Karimi-Sari Hamidreza, Safiabadi Mahdi, Dolatimehr Fardin, Okhovatian Mohammadreza, Ramezani-Binabaj Mahdi, Pishgoo Bahram
a Student Research Committee , Baqiyatallah University of Medical Sciences , Tehran , Iran.
b Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences , Tehran , Iran.
Acta Cardiol. 2017 Oct;72(5):522-528. doi: 10.1080/00015385.2017.1306309. Epub 2017 Jul 6.
Some studies aimed to evaluate the relationship between HbA1c and coronary artery disease (CAD). However, it is well known that long-term glycometabolic disorders put the heart at risk for CAD. Considering the inconsistencies between previous studies, this study aimed to investigate the relationship between HbA1c and coronary artery atherosclerosis.
A cross-sectional study was conducted on 411 non-diabetic patients who underwent their first coronary angiography between November 2013 and December 2014 in Baqiyatallah Hospital. Blood samples were taken before angiography. Coronary angiograms were reported and reviewed by two cardiologists according to the Gensini score. They were not aware about the patients' HbA1c level. Severity of CAD was determined through ascertaining the prevalence of multi-vessel disease, extent of CAD (single-, two- or three-vessel disease or left main stem stenosis (>50%)). Data analysis was performed by using SPSS software.
A total of 411 patients (252 men and 159 women) were evaluated. Angiography was normal in 67 patients (16.3%), 30.7% had single-vessel disease (SVD), and 29.1%, 20.7% and 3.2% had two-, three- and multivessel disease, respectively. Based on the ROC curve, the HbA1c was able to differentiate between patients with and without coronary atherosclerosis (p < .001, cut-off point = 5.45). The cut-off points for differentiation of severe CAD and patients with 75-100% stenosis of coronary artery were 5.55 (p < .001) and 5.65 (p < .001), respectively.
The present study demonstrated that HbA1c might be an independent diagnostic factor in non-diabetic patients with severe coronary atherosclerosis.
一些研究旨在评估糖化血红蛋白（HbA1c）与冠状动脉疾病（CAD）之间的关系。然而，众所周知，长期糖代谢紊乱会使心脏面临患CAD的风险。鉴于先前研究结果存在不一致性，本研究旨在探讨HbA1c与冠状动脉粥样硬化之间的关系。
对2013年11月至2014年12月期间在巴基耶塔拉医院首次接受冠状动脉造影的411例非糖尿病患者进行了一项横断面研究。在造影前采集血样。两位心脏病专家根据Gensini评分对冠状动脉造影结果进行报告和评估。他们不知道患者的HbA1c水平。通过确定多支血管病变的患病率、CAD的范围（单支、两支或三支血管病变或左主干狭窄（>50%））来确定CAD的严重程度。使用SPSS软件进行数据分析。
共评估了411例患者（252例男性和159例女性）。67例患者（16.3%）造影结果正常，30.7%患有单支血管病变（SVD），29.1%、20.7%和3.2%分别患有两支、三支和多支血管病变。根据ROC曲线，HbA1c能够区分有和没有冠状动脉粥样硬化的患者（p <.001，截断点 = 5.45）。区分严重CAD患者和冠状动脉狭窄75 - 100%患者的截断点分别为5.55（p <.001）和5.65（p <.001）。
本研究表明，HbA1c可能是重度冠状动脉粥样硬化非糖尿病患者的一个独立诊断因素。
