Glycosylated Haemoglobin A1c as An Independent Marker Predicting Coronary Artery Disease in Non-diabetic Patient Population in Primary Healthcare in Turkey: A crosssectional study
Abstract Background: In our role as a preventive physician, there is a need for cheap and accessible biochemical markers that will allow the determination of the risk of coronary artery disease. We aimed to research the value of glycosylated haemoglobin (HbA1c) in the prediction of coronary artery disease. Methods: Patients aged between thirty and ninety years who were admitted to outpatient clinic of Cardiology department in a university hospital between January 2016 and June 2018 for angiography for various reasons were retrospectively screened. Patients with known diabetes or patients with HbA1c of 6.5 or above were excluded from the study. Comparative HbA1c data were obtained according to the stenosis groups and statistical significance was sought. Logistic regression analysis was used to investigate the risk factors affecting stenosis positivity. Results: A total of 247 patients were identified, 120 patients without any stenosis in any coronary artery, 56 patients with> 50% stenosis in one coronary artery, and 71 patients with > 50% stenosis in more than one coronary artery. There was a statistically significant difference between HbA1c measurements according to the degree of stenosis (p = 0.001 and p <0.01, respectively). The odd ratio for HbA1c was 6.260 (95% CI: 3,160-12,401). According to the stenosis positivity, the cut off point for HbA1c was found to be 5.6 and above. In the regression analysis, HbA1c was an independent risk factor for coronary artery disease. One unit increase in HbA1c measurements increases the risk of stenosis positive to 12.424 times (95% CI: 5,990-25,767).Conclusions: The study showed HbA1c can be used as an independent marker in determining the probability and severity of coronary artery disease in non-diabetic individuals and as an useful marker in primary care predicting coronary artery disease (CAD).