Vol. 7, Issue 2, Part A (2025)

Introduction: Coronary artery disease (CAD) continues to be the primary cause of death globally. Glycated hemoglobin (HbA1c), a recognized indicator of prolonged glycemic regulation, has been associated with both microvascular and macrovascular consequences. Nonetheless, scant evidence correlate HbA1c with the angiographic severity of coronary artery disease as assessed by the SYNTAX score in diabetic individuals.
Aim: The present study was done with an aim to evaluate the relationship between HbA1c level and severity of coronary artery disease in diabetic patients using SYNTAX score in a cohort of proven Coronary Artery Disease (CAD) on angiography. 
Material and methods: A cross-sectional study was performed at a tertiary care hospital over six months, enrolling 170 diabetic patients with angiographically verified coronary artery disease (CAD). Patients were categorized into four HbA1c quartiles: <6.7%, 6.7-7.1%, 7.1-7.6%, and >7.6%. The complexity of coronary lesions was evaluated using the SYNTAX score, and vascular involvement was recorded. The statistical analysis encompassed ANOVA, chi-square tests, Pearson’s correlation, and multivariate logistic regression.
Results: The average age of the group was 58.4 ± 9.2 years, comprising 68.2% men.  Common comorbidities included hypertension (62.9%), dyslipidemia (48.8%), and a history of smoking (39.4%).  The average HbA1c was 7.24 ± 0.68%.  SYNTAX scores shown a progressive increase across quartiles (14.2 ± 4.8, 18.5 ± 5.1, 21.7 ± 6.2, and 26.3 ± 7.1; p < 0.001).  The prevalence of multivessel disease increased from 22.5% in the lowest HbA1c group to 70.4% in the highest (p < 0.001).  HbA1c had a substantial correlation with the SYNTAX score (r = 0.62, p < 0.001) and served as an independent predictor of severe coronary artery disease (OR 1.45; 95% CI: 1.18-1.78; p < 0.001).
Conclusion: In diabetic patients, elevated HbA1c levels are highly correlated with higher SYNTAX scores and a greater prevalence of multivessel coronary artery disease (CAD). HbA1c functions as an independent indicator of CAD severity, highlighting the significance of effective glycemic management in reducing coronary atherosclerotic load.