Relationship between fasting glucose, HbA1c levels, and the SYNTAX Score 2 in patients with non-ST-elevation myocardial infarction

Abstract

We evaluated if admission glycosylated hemoglobin (HbA(1c)) and fasting glucose levels are correlated with the severity of coronary artery disease (CAD) in non-ST-elevation myocardial infarction (NSTEMI), nondiabetic, patients. Coronary artery disease severity, according to the anatomical synergy between percutaneous coronary intervention (PCI) with taxus and cardiac surgery (SYNTAX) score 2 (SSII), was retrospectively evaluated in 359 nondiabetic patients hospitalized with NSTEMI who underwent coronary angiography. Glucose intolerance was assessed by serum fasting glucose and HbA(1c) levels. We stratified patients according to tertiles of SSII (<= 21.5, 21.5-30.6, and >= 30.6). These score ranges were defined as SSII low, SSII mid, and SSII high, respectively. The average age of the patients was 57.1 +/- 10.9 years; 189 (52.1%) patients were males. The average fasting glucose was 114 +/- 52 mg/dL, HbA(1c) was 5.8% +/- 0.9%, and SSII was 18.9 +/- 10.3. A stronger correlation was found between HbA(1c) and SSII than fasting glucose and SSII (r1 = 0.901, P < .001, r2 = 0.378, P < .001, respectively), and HbA(1c) level and hypertension were independent risk factors for SSII high (odds ratio [OR]: 2.2 (95% CI: 0.5-9.0, P < .001; OR: 1.1 (1.0-1.3), P = .007, respectively). In conclusion, in nondiabetic patients with NSTEMI, HbA(1c) levels correlated with CAD severity as measured by the SSII.