Role of hemoglobin A1c in prediction of high-risk plaque and plaque extent assessed by coronary computed tomography angiography

Abstract

Background Diabetes mellitus is a worldwide disease that is related to the distribution and severity of coronary artery disease (CAD). Hemoglobin A1c (HbA1c) was reported in many studies to predict the extent and severity of CAD. Coronary computed tomograghy angiograghy (CCTA) is a useful noninvasive tool for detecting CAD. Aim The study aimed to evaluate the role of HbA1c in prediction of high-risk plaque and plaque extent assessed by CCTA among patients with diabetes mellitus. Patients and methods A total of 30 diabetic patients who had chest pain or dyspnea or had multiple risk factors of CAD were included in the study. HbA1c was estimated in all patients. The severity and extent of CAD among study population were assessed by several CCTA scores including coronary artery calcium score, segment involvement score (SIS), and segment stenosis score (SSS). Results The patients were classified into two groups according to values of HbA1c: group 1 included patients with HbA1c less than 7.0 (14 patients), and group 2 included patients with HbA1c more than or equal to 7.0 (16 patients). The study revealed a significant increase in the SIS, SSS, coronary artery calcium score, number of all lesions, number of obstructive lesions, and number of vessels affected in patients in group 2 compared with those in group 1. There was a strong positive correlation between HbA1c and SIS, SSS, and the presence of obstructive lesions (r=0.663, 0.659, and 0.589, respectively). Conclusion HbA1c is associated with the extent and severity of CAD.