Kenji Norimatsu1, Shin-Ichiro Miura2, Yasunori Suematsu1, Yuhei Shiga1, Yuiko Miyase1, Ayumi Nakamura1, Mayumi Yamada3, Akira Matsunaga3, Keijiro Saku4. 1. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan. 2. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan. Electronic address: miuras@cis.fukuoka-u.ac.jp. 3. Department of Laboratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan. 4. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan; Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka, Japan.
Abstract
OBJECTIVE: We investigated the associations between serum levels of glycated albumin (GA) or hemoglobin A1c (HbA1c) and the presence of coronary artery disease (CAD) in patients who underwent coronary computed tomography angiography (CTA). METHODS AND RESULTS: The study consisted of 244 consecutive patients who underwent CTA and in whom we could measure the levels of both GA and HbA1c. Any narrowing of the normal contrast-enhanced lumen to >50% that could be identified in multiplanar reconstructions or cross-sectional images by CTA was defined as significant stenosis in CAD. We divided the patients into two groups: CAD group (n=72) and non-CAD group (n=172), as assessed by CTA. The CAD group showed significantly higher GA and HbA1c than the non-CAD group. GA and HbA1c showed a positive correlation (r=0.551, p<0.0001). A multivariate logistic regression analysis was performed to examine the associations between the presence of CAD and age, gender, body mass index, and coronary risk factors (hypertension, dyslipidemia, and smoking), in addition to GA and HbA1c. Age [odds ratio (OR): 1.04, p=0.02], gender (OR: 2.84 p=0.01), hypertension (OR: 3.20, p=0.01), and GA (OR: 1.16, p=0.03) were identified as significant independent variables that predicted the presence of CAD. In particular, GA (OR: 1.30, p=0.02) was the only predictor of the presence of CAD in the diabetes mellitus group by a multivariate logistic regression analysis. We defined the cut-off value of GA for the prediction of CAD in patients with diabetes as 17.9% (sensitivity 0.639, specificity 0.639) by a receiver-operating characteristic curve analysis. CONCLUSION: GA may be superior to HbA1c as a marker for evaluating the presence of CAD.
OBJECTIVE: We investigated the associations between serum levels of glycated albumin (GA) or hemoglobin A1c (HbA1c) and the presence of coronary artery disease (CAD) in patients who underwent coronary computed tomography angiography (CTA). METHODS AND RESULTS: The study consisted of 244 consecutive patients who underwent CTA and in whom we could measure the levels of both GA and HbA1c. Any narrowing of the normal contrast-enhanced lumen to >50% that could be identified in multiplanar reconstructions or cross-sectional images by CTA was defined as significant stenosis in CAD. We divided the patients into two groups: CAD group (n=72) and non-CAD group (n=172), as assessed by CTA. The CAD group showed significantly higher GA and HbA1c than the non-CAD group. GA and HbA1c showed a positive correlation (r=0.551, p<0.0001). A multivariate logistic regression analysis was performed to examine the associations between the presence of CAD and age, gender, body mass index, and coronary risk factors (hypertension, dyslipidemia, and smoking), in addition to GA and HbA1c. Age [odds ratio (OR): 1.04, p=0.02], gender (OR: 2.84 p=0.01), hypertension (OR: 3.20, p=0.01), and GA (OR: 1.16, p=0.03) were identified as significant independent variables that predicted the presence of CAD. In particular, GA (OR: 1.30, p=0.02) was the only predictor of the presence of CAD in the diabetes mellitus group by a multivariate logistic regression analysis. We defined the cut-off value of GA for the prediction of CAD in patients with diabetes as 17.9% (sensitivity 0.639, specificity 0.639) by a receiver-operating characteristic curve analysis. CONCLUSION: GA may be superior to HbA1c as a marker for evaluating the presence of CAD.
Authors: Run Du; Rui Yan Zhang; Lin Lu; Ying Shen; Li Jin Pu; Zheng Bin Zhu; Qi Zhang; Jian Hu; Zhen Kun Yang; Feng Hua Ding; Jian Sheng Zhang; Wei Feng Shen Journal: Cardiovasc Diabetol Date: 2018-11-27 Impact factor: 9.951