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糖尿病急性冠状动脉综合征患者血管造影模式分析:与糖化血红蛋白水平的相关性

Analysis of Angiographic Patterns in Acute Coronary Syndrome Patients With Diabetes Mellitus: Correlation With HbA1c Levels.

作者信息

Garg Yug, Marthandam Manickandan Arun Prabhu, Ghori Hana Khan, Rameshbabu Sushmitha, Mohammed Imaduddin, Mohamed Saeed, Mustafa Chiniwala Hussain, Mohamed Saad, Doshi Bhavya, Pascal Shoraf

机构信息

Endocrinology Diabetes Medicine, Samatvam Diabetes Endocrinology and Medical Center, Bangalore, IND.

Internal Medicine, Central America Health Sciences University Belize Medical College, Ladyville, BLZ.

出版信息

Cureus. 2024 Oct 21;16(10):e72028. doi: 10.7759/cureus.72028. eCollection 2024 Oct.

Abstract

Background The relation of diabetes mellitus with cardiovascular diseases is well-known, even acute coronary syndrome (ACS). High levels of glycated haemoglobin (HbA1c) are used is a sign of long-term glycemic control and may be associated with severity in coronary artery disease (CAD). In this particular setting, the aim of this investigation was to examine the relationship between the HbA1c values and the angiographic patterns of patients who were admitted with an ACS diagnosis. Methodology A cross-sectional study included 120 patients diagnosed with ACS. The criteria for eligibility included patients with ST-elevation myocardial infarction, unstable angina, and non-ST elevation myocardial infarction with history of documented diabetes mellitus. Every patient had a suitable clinical examination, had their HbA1c checked, and had coronary angiography to determine the severity of their CAD. Descriptive statistics and ANOVA were performed for statistical analyses to determine the connection between angiographic patterns and HbA1c. Results Patients with elevated HbA1c levels demonstrated a strong association with severe coronary artery disease. Notably, those with HbA1c exceeding 10.5% exhibited significant triple vessel disease and Type C lesions, indicative of advanced coronary artery disease. Statistical analyses revealed a marked difference in angiographic patterns across various HbA1c categories (p < 0.05). Conclusion The findings of this study suggest that maintaining optimal HbA1c levels is essential for mitigating the severity of coronary artery disease in patients with ACS. Moreover, effective glycemic control may be protective against advanced coronary atherosclerosis and subsequent cardiovascular complications in both diabetic and non-diabetic individuals.

摘要

背景 糖尿病与心血管疾病的关系众所周知,甚至与急性冠状动脉综合征(ACS)也是如此。糖化血红蛋白(HbA1c)水平升高被用作长期血糖控制的指标,并且可能与冠状动脉疾病(CAD)的严重程度相关。在这种特定情况下,本研究的目的是检查ACS诊断患者的HbA1c值与血管造影模式之间的关系。

方法 一项横断面研究纳入了120例诊断为ACS的患者。入选标准包括患有ST段抬高型心肌梗死、不稳定型心绞痛以及有记录的糖尿病病史的非ST段抬高型心肌梗死患者。每位患者均接受了适当的临床检查,检查了HbA1c,并进行了冠状动脉造影以确定其CAD的严重程度。进行描述性统计和方差分析以进行统计分析,以确定血管造影模式与HbA1c之间的联系。

结果 HbA1c水平升高的患者与严重冠状动脉疾病密切相关。值得注意的是,HbA1c超过10.5%的患者表现出明显的三支血管病变和C型病变,这表明冠状动脉疾病已处于晚期。统计分析显示,不同HbA1c类别之间的血管造影模式存在显著差异(p < 0.05)。

结论 本研究结果表明,维持最佳HbA1c水平对于减轻ACS患者冠状动脉疾病的严重程度至关重要。此外,有效的血糖控制可能对糖尿病和非糖尿病个体预防晚期冠状动脉粥样硬化及随后的心血管并发症具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a73/11502981/f1937482aa5f/cureus-0016-00000072028-i01.jpg

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