Prognostic Significance of Glycosylated Hemoglobin Level in Prediabetic and Newly Diagnosed Diabetic Patients with Acute Coronary syndrome: A Multi-Ethnic Population Study in Saudi Arabia

Abstract

Background: DM is a slowly progressive disease that takes many years to progress from prediabetic to diabetic state. We aimed at finding prognostic significance of varying glycosylated hemoglobin level in prediabetic and newly diagnosed diabetic patients with acute coronary syndrome (ACS) in a multi-ethnic population in Saudi Arabia.
Results: The study evaluated 927 patients presented ACS and no history of DM before. Newly diagnosed DM group showed Significant prevalence of hypertension (???? value 0.01) with more prevalence of hypertension in Arabic patients (???? value 0.005). New diabetic patients represent statistically significant rise in number of patients having multivessel diseases, slow / no reflow complications or bifurcation lesions (???? value 0.031,0.045, and 0.05) respectively. Hospital stay was significantly higher in this group with mean value of 3.38±3.1 (???? value < 0.046). Receiver operating characteristic (ROC) curve for HbA1c showed area under the curve was 0.759, and 0.764 with sensitivity 77.2% and 82% and specificity 74.9% and 77% using a cutoff value > 6.08 % and 8% for prediction of dyslipidemia in prediabetic and diabetic groups, respectively.
Conclusion: we identified that HbA1c has a good sensitivity and specificity for prediction of dyslipidemia in prediabetics and newly diagnosed diabetics patients presented with ACS, but it failed to predict dyslipidemia in non-diabetics. The present study showed that high HbA1c level in admission in newly diagnosed diabetic’s patients presented by ACS is a potential prognostic factor for multiverses disease and bifurcation lesions.