Admission glucose, fasting glucose, HbA1c levels and the SYNTAX score in non-diabetic patients undergoing coronary angiography.

BACKGROUND: Pre-diabetic state is a major risk factor for the development of diabetes and cardiovascular events. Admission glucose, fasting glucose and HbA1c levels have an effect on prognosis in patients with pre-diabetes and in non-diabetic individuals. The aim of the present study was to investigate which of the following glucometabolic markers (admission glucose, fasting glucose and HbA1c levels) is correlated with the severity of coronary artery disease (CAD) in non-diabetic patients.

METHODS: CAD severity according to SYNTAX score was prospectively evaluated in 226 non-diabetic patients hospitalized with myocardial infarction or stable angina and underwent coronary angiography. Glucose intolerance was assessed by serum admission glucose, fasting glucose and HbA1c levels. Logistic regression analysis was used to evaluate which glucometabolic factor has the strongest correlation with CAD severity.

RESULTS: HbA1c was the only glucometabolic factor associated with SYNTAX score above 22 (OR = 3.03, CI 95% 1.03-8.9, p = 0.04). HbA1c was also significantly associated with CAD severity in subgroup analysis (MI and stable angina).

CONCLUSIONS: In non-diabetic patients with myocardial infarction or stable angina, HbA1c levels correlate with CAD severity as measured by the SYNTAX score. No correlation was found between admission glucose or fasting glucose levels and CAD severity.