Archives of the Turkish Society of Cardiology
Relationship between HbA1c and coronary flow rate in patients with type 2 diabetes mellitus and angiographically normal coronary arteries [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2010; 38(6): 405-410

Relationship between HbA1c and coronary flow rate in patients with type 2 diabetes mellitus and angiographically normal coronary arteries

Mehmet Birhan Yılmaz1, Alim Erdem2, Osman Can Yontar2, Savaş Sarıkaya3, Ahmet Yılmaz1, Nihat Madak4, Filiz Karadaş5, İzzet Tandoğan1
1Department of Cardiology, Cumhuriyet University, Sivas, Turkey
2Department of Cardiology, Sivas State Hospital, Sivas, Turkey
3Department of Cardiology, Muş State Hospital, Muş, Turkey
4Department of Cardiology, Turgutlu State Hospital, Manisa, Turkey
5Department of Cardiology, Aydın State Hospital, Aydın, Turkey


OBJECTIVES
We examined the relationship between glycosylated hemoglobin (HbA1c) level and coronary flow rate in patients with type 2 diabetes mellitus (DM) and angiographically normal coronary arteries.

STUDY DESIGN
The study included 54 consecutive patients (36 males, 18 females; age range 37 to 72 years) with type 2 DM, whose coronary arteries were found normal on coronary angiography. All patients underwent echocardiography and plasma HbA1c levels were measured before coronary angiography. To determine slow coronary flow (SCF), coronary flow rates of the left anterior descending (LAD), circumflex (Cx), and right coronary (RCA) arteries were assessed using the TIMI frame count (TFC) method.

RESULTS
None of the patients had echocardiographic abnormalities. The mean HbA1c level was 7.4±2.0%, and the mean TFCs were 34.3±6.5, 22.4±3.5, and 20.4±2.2 for the LAD, Cx, and RCA, respectively. HbA1c levels were <7% in 26 patients, and ≥7% in 28 patients. Thirty-eight patients (70.4%) were found to have SCF in at least one coronary artery. TIMI frame counts of all three coronary arteries were significantly greater in patients in whom HbA1c was ≥7% (p<0.001). TIMI frame counts showed significant correlations with the HbA1c level (LAD: r=0.782; Cx: r=0.707; RCA: r=0.515; p<0.001 for all). The mean HbA1c level was significantly higher in patients with SCF compared to patients without SCF (7.8±1.9% vs. 5.6±0.9%; p<0.001). The incidence of SCF was significantly greater in patients with HbA1c ≥7.0% than those with HbA1c <7.0% (96.4% vs. 61.5%; p=0.004). Increased HbA1c (≥7%) significantly increased the risk for SCF in at least one coronary artery (OR=16.875; 95% CI 1.972-144.38).

CONCLUSION
Our findings suggest that there is a strong correlation between the HbA1c level and coronary flow rate.

Keywords: Blood flow velocity, coronary circulation; diabetes mellitus, type 2/complications; endothelium, vascular; hemoglobin A, glycosylated; hyperglycemia/complications

How to cite this article
Mehmet Birhan Yılmaz, Alim Erdem, Osman Can Yontar, Savaş Sarıkaya, Ahmet Yılmaz, Nihat Madak, Filiz Karadaş, İzzet Tandoğan. Relationship between HbA1c and coronary flow rate in patients with type 2 diabetes mellitus and angiographically normal coronary arteries. Turk Kardiyol Dern Ars. 2010; 38(6): 405-410

Corresponding Author: Alim Erdem, Türkiye
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