title: The relationship between glycated hemoglobin and complexity of coronary artery lesions among older patients with diabetes mellitus.
abstract: OBJECTIVE
  Glycated hemoglobin (HbA1c) is associated with an increased risk of cardiovascular disease. The aim of this study was to examine the relationship between HbA1c levels and the complexity of coronary artery lesions among the older patients with diabetes mellitus (DM).
  
  
  METHODS
  This retrospective study enrolled a total of 3805 consecutive type 2 DM patients aged 60 years and older who underwent their first elective coronary angiography and had their HbA1c levels measured at the Chinese PLA General Hospital between December 2005 and December 2012.The complexity of the coronary artery lesions was evaluated using the Syntax score, and the subjects were divided into three groups according to their HbA1c levels. Logistic regression and Pearson correlation were used to analyze the association between the measured HbA1c levels and Syntax score.
  
  
  RESULTS
  The mean age was 72.3±10.6 years. The higher HbA1c levels were significantly associated with higher Syntax score (p<0.001). The unadjusted correlation coefficient of HbA1c levels and the Syntax score was 0. 371 (p<0.001). In addition, the higher HbA1c categories were able to independently predict patients with intermediate or high Syntax score (Syntax score ≥23) after adjustment for age, sex, hypertension, smoking, dyslipidemia and creatinine levels in the logistic regression analysis.
  
  
  CONCLUSIONS
  HbA1c is significantly associated with the complexity of coronary lesions among older patients with DM. A higher HbA1c value is an independent predictor of the prevalence of complex coronary lesions. Further prospective multi-centre studies are needed to confirm this finding.
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Jinling
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Radiology, Zhaoyuan People's Hospital, Shandong, China.
authors.forename: Xiujie
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yutang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yuexiang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003331:Coronary Vessels / Q000473:pathology*; D048909:Diabetes Complications / Q000473:pathology*; D003920:Diabetes Mellitus / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism* / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human