title: Glycated haemoglobin is correlated with the severity of coronary artery disease independently of traditional risk factors in young patients.
abstract: BACKGROUND
  In this study, we aimed to investigate the relationship between glycated haemoglobin (HbA1c) levels and the severity of coronary artery disease (CAD) in < 40 years old patients.
  
  
  METHODS
  The study population consisted of 211 premature coronary atherosclerotic patients (pCAP) (aged 36.4 ± 2.5 years) and 160 control subjects (36.4 ± 2.4 years). The severity of CAD was evaluated by the Gensini scoring system. HbA1c levels and the other basic biochemical parameters were analysed, and relations with severity of CAD were evaluated.
  
  
  RESULTS
  There were statistically significant differences in serum HbA1c levels between the two groups (pCAP = 6.1 ± 1.8%, control = 4.7 ± 1.2%, p < 0.001). HbA1c levels significantly positively correlated with the Gensini score in pCAP (r = 0.662, p < 0.001). In linear multivariate regression analysis (including age, sex, HbA1c, smoking, diabetes mellitus and hypertension as dependent parameters), only HbA1c was found to be an independent risk factor for the presence of severe CAD (Beta = 0.374, p < 0.001). In ROC curve analysis, the optimal cut-off value of HbA1c to predict severe CAD was 6.52%, with 74.4% sensitivity and 75.1% specificity (area under the curve 0.781, 95% confidence interval 0.661 to 0.901, p < 0.001).
  
  
  CONCLUSIONS
  HbA1c levels were found to be correlated with the Gensini score in pCAP with and without diabetes. In this respect, glucose metabolism abnormalities, indicated by HbA1c, may play an important role in premature CAD.
authors.affiliation: Department of Cardiology, Izzet Baysal Medical Faculty, Bolu, Turkey.
authors.forename: S Selim
authors.initials: SS
authors.lastname: Ayhan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
authors.forename: Serkan
authors.initials: S
authors.lastname: Ozturk
authors.forename: Aytekin
authors.initials: A
authors.lastname: Alcelik
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Ozlu
authors.forename: Alim
authors.initials: A
authors.lastname: Erdem
authors.forename: Kemalettin
authors.initials: K
authors.lastname: Erdem
authors.forename: Fatma Hizal
authors.initials: FH
authors.lastname: Erdem
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazici
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human