Glycated hemoglobin as a predictor of adverse cardiovascular outcomes in patients with diabetes mellitus and acute coronary syndrome

Objective: To determine the prognostic significance of glycated hemoglobin (HbA1c) levels in assessing the risk of adverse cardiovascular outcomes in patients with type 2 diabetes mellitus who have had acute coronary syndrome. Materials and Methods: A prospective study analyzed data from 72 patients with type 2 diabetes mellitus and acute coronary syndrome. Patients were divided into two groups: the first group included patients with glycated hemoglobin (HbA1c) <=7% (n=21), and the second group included patients with HbA1c >7% (n=51). The groups were balanced for key clinical characteristics. Results: In patients with HbA1c level >7%, statistically significantly higher scores were found on the SYNTAX (27.2±6.60 vs. 24.3±5.00; p=0.048) and GRACE (114.8±22.3 vs. 105.4±19.0; p=0.041) scales. The frequency of adverse cardiovascular events during the hospital period did not differ, but after 12 months it was significantly higher in the group with HbA1c >7% (29.4% vs. 14.3%; p=0.022). Correlation analysis confirmed significant direct relationships between the HbA1c level and SYNTAX (r=0.385; p<0.001) and GRACE (r=0.275; p=0.019) scores. Conclusion: HbA1c levels are an important indicator of the severity of coronary atherosclerosis and the risk of cardiovascular complications in patients with type 2 diabetes and acute coronary syndrome. The study results convincingly support the need for strict glycemic control, which can significantly improve the prognosis for this group of patients.