The Importance of Managing HbA1c in Coronary Artery Disease: Keep It Low

Djanggan Sargowo


Coronary Artery Disease (CAD) is the most prevalent cardiovascular disease, which remains the leading cause of death worldwide. In Indonesia, it accounts for approximately 1.5% of the entire population. Diabetes mellitus (DM) is taken into consideration as one of the most potent risk factors for cardiovascular diseases. HaemoglobinA1c (HbA1c) reflects a long-term glycemic control and is used as a valuable diabetes biomarker. High serum glucose levels, expressed as glycated hemoglobin levels in diabetics or non-diabetics, are related to varying degrees of systemic inflammation and promote the release of the proinflammatory cytokines. The association between higher glycated serum HbA1c levels and the severity of the coronary disease is well known. The predictive value of HbA1c for CAD severity, re-hospitalization, and the mortality of cardiovascular disease had been studied extensively since 2004. Numerous previous trials discovered that severity of CAD correlated with the elevation of HbA1c levels, suggesting it as a broad surrogate marker for CAD. Thus, HbA1c is currently considered as an independent risk factor for CAD. A higher level of HbA1c and the presence of factors associated with ongoing atherosclerosis and extensive CAD are concomitantly contributing to the higher major adverse cardiovascular events (MACEs) incidence and long-term mortality.


Coronary artery disease; Diabetes mellitus; HbA1c

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Hanson MA, Fareed MT, Argenio SL, Agunwamba AO, Hanson TR.Coronary artery disease. Primary Care: Clinics in Office Practice 2013;40:1-16.

Robby HD KK. The Risk Factor of Hypertension and Sex to Coronary Artery Disease at jenursari Islamic Hospital Surabaya The Indonesian journal of Public Health 2018;13(1):134.

Biomy R AA. The Relation between Glycated Hemoglobin and Severity of Coronary Artery Disease in Non-Diabetic Patients with Acute Coronary Syndrome. Journal of Cardiology & Current Research 2017;8(4):8-11.

Stolar M. Glycemic Control and Complications in Type 2 Diabetes Mellitus. The American Journal of Medicine 2010;123:S3-S11.

Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes: The Atherosclerosis Risk in Communities Study. Archives of Internal Medicine 2005;165:1910-6.

Leong A, Chen J, Wheeler E, et al. Mendelian Randomization Analysis of Hemoglobin A1c as a Risk Factor for Coronary Artery Disease. Diabetes Care 2019;42:1202.

Ghaffari S, Niafar F, Separham A, Niafar M, Pourafkari L, Nader ND. Association between HbA1c levels with severity of coronary artery disease and short-term outcomes of acute ST-elevation myocardial infarction in nondiabetic patients. Therapeutic Advances in Cardiovascular Disease 2015;9:305-13.

Hong L-F, Li X-L, Guo Y-L, et al. Glycosylated hemoglobin A1c as a marker predicting the severity of coronary artery disease and early outcome in patients with stable angina. Lipids in Health and Disease 2014;13:89.

Habib S, Ullah SZ, Saghir T, et al. The Association between Hemoglobin A1c and the Severity of Coronary Artery Disease in Non-diabetic Patients with Acute Coronary Syndrome. Cureus 2020;12:e6631-e.

Geng J, Zhang Y, Wang B, Xie J, Xu B, Li J. Glycosylated hemoglobin levels and clinical outcomes in nondiabetic patients with coronary . artery disease: A meta-analysis. Medicine (Baltimore) 2017;96:e6784-e



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