Value of Glycated Hemoglobin (HbA1c%) as an Indicator of Severity of Acute Coronary Syndrome in Non-Diabetic Adults

Abstract
Background: Glycated hemoglobin (HbA1c%) is a de-pendable indicator of glycemic status in both diabetic and non-diabetic patients and a good indicator of Coronary Artery Disease (CAD) presence and its severity.
Aim of Work: Correlating (HbA1c%) level with the severity of acute coronary syndrome presentation, degree of affection of systolic and diastolic function of the cardiac muscle measured by TTE and degree of coronary vasculature affection as shown by diagnostic coronary angiography, in non-diabetic patients.
Methodology: A cross sectional study conducted from May 2016 to April 2017, at Cardiovascular Medicine Depart-ment, Tanta University Hospitals in Gharbia Governorate, Egypt. 123 non-diabetic patients presented to our CCU with Acute Coronary Syndrome (ACS), had Trans-Thoracic Echocardiography (TTE), diagnostic coronary angiography and SYNTAX score was calculated based on its results. HbA1c% level was measured and correlated to previous parameters.
Result: Patients was divided into 3 tertiles according to their HbA1c% level, <_5.5, 5.6-5.9 and 6-6.4. Significant relationship was detected between HbA1 c% level and severity of ACS presentation. Moderate positive correlation was found between HbA1c% level and SYNTAX score (r.=0.504, p= 0.001). Also, moderate positive correlation was found between (HbA1c%) level and number of affected coronary vessels as detected by diagnostic coronary angiography (r.=0.397, p= 0.001). Moderate negative correlation was found between (HbA1c%) level and LV systolic function as measured by simpson method through TTE (r.=–0.466, p=0.001).
Conclusion: HbA1c% level is a fundamental marker for chronic glycemia and could be utilized as an independent predictor of CAD presence, severity of acute emergent pres-entation and degree of cardiac muscle affection due to CAD even in non-diabetic individuals.