title: Hemoglobin A(1c) in nondiabetic patients: an independent predictor of coronary artery disease and its severity.
abstract: OBJECTIVE
  To examine the association between hemoglobin A(1c) (HbA(1c)) and the presence, severity, and complexity of angiographically proven coronary artery disease (CAD) in nondiabetic patients.
  
  
  METHODS
  We performed a single-center, observational, cross-sectional study of 1141 consecutive nondiabetic patients who underwent coronary angiography from January 1, 2011, through December 31, 2011. The study population was divided into 4 interquartiles according to HbA(1c) levels (<5.5%, 5.5%-5.7%, 5.8%-6.1%, and >6.1%).
  
  
  RESULTS
  Patients with higher HbA(1c) levels tended to be older, overweight, and hypertensive, had higher blood glucose levels, and had lower glomerular filtration rates. Higher HbA(1c) levels were associated in a graded fashion with the presence of CAD, disease severity (higher number of diseased vessels and presence of left main and/or triple vessel disease), and disease complexity (higher SYNTAX score, higher number of patients in intermediate or high SYNTAX tertiles, coronary calcium, and chronic total occlusions). After adjustment for major conventional cardiovascular risk factors, compared with patients with HbA(1c) levels less than 5.5%, the odds ratios of occurrence of CAD in the HbA(1c) quartiles of 5.5% to 5.7%, 5.8% to 6.1%, and greater than 6.1% were 1.8 (95% CI, 1.2-2.7), 3.5 (95% CI, 2.3-5.3), and 4.9 (95% CI, 3.0-8.1), respectively.
  
  
  CONCLUSIONS
  The HbA(1c) level has a linear incremental association with CAD in nondiabetic individuals. The HbA(1c) level is also independently correlated with disease severity and higher SYNTAX scores. Thus, HbA(1c) measurement could be used to improve cardiovascular risk assessment in nondiabetic individuals.
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Garg
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. Electronic address: drnagaraj_moorthy@yahoo.com.
authors.forename: Nagaraja
authors.initials: N
authors.lastname: Moorthy
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Kapoor
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Satyendra
authors.initials: S
authors.lastname: Tewari
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Sudeep
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Sinha
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Anshika
authors.initials: A
authors.lastname: Shrivastava
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Goel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human