The relationship between hemoglobin A1c levels and thrombus load in patients with type 2 diabetes mellitus and non-ST-segment elevation myocardial infarction

Dursun Topal; Ferit Onur Mutluer; Omur Aydin; Hakan Cakir; Selcuk Kanat; Burhan Aslan; Fahri Er; Abdulkadir Uslu; Veciha Ozlem Bozkaya; Muhammed Keskin; Remzi Karsi; Mustafa Yilmaz; Enbiya Aksakal; Mehmet Demir; Erhan Tenekecioglu

doi:10.4103/jrms.JRMS_997_18

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ORIGINAL ARTICLE

Year : 2021 | Volume : 26 | Issue : 1 | Page : 118

The relationship between hemoglobin A1c levels and thrombus load in patients with type 2 diabetes mellitus and non-ST-segment elevation myocardial infarction

Dursun Topal¹, Ferit Onur Mutluer², Omur Aydin³, Hakan Cakir¹, Selcuk Kanat¹, Burhan Aslan⁴, Fahri Er⁵, Abdulkadir Uslu⁶, Veciha Ozlem Bozkaya⁷, Muhammed Keskin⁸, Remzi Karsi⁹, Mustafa Yilmaz¹⁰, Enbiya Aksakal¹¹, Mehmet Demir¹, Erhan Tenekecioglu¹
¹ Department of Cardiology, Bursa Education and Research Hospital, Health Sciences University, Bursa, Turkey
² Department of Cardiology, Faculty of Medicine, Koc University, Istanbul, Turkey
³ Department of Cardiology, Kilis State Hospital, Kilis, Turkey
⁴ Department of Cardiology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey
⁵ Department of Cardiology, Agri State Hospital, Agri, Turkey
⁶ Department of Cardiology, Kosuyolu Education and Research Hospital, Istanbul, Turkey
⁷ Department of Cardiology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey
⁸ Department of Cardiology, Istanbul Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
⁹ Department of Midwifery, School of Health Sciences, The Konya Chamber of Commerce Karatay University, Konya, Turkey
¹⁰ Department of Cardiology, Faculty of Medicine, Uludağ University, Bursa, Turkey
¹¹ Department of Cardiology, Faculty of Medicine, Medicana Hospital, Biruni University, Bursa, Turkey

Correspondence Address:
Dr. Erhan Tenekecioglu
Department of Cardiology, Bursa Education and Research Hospital, Health Sciences University, Yildirim, Bursa
Turkey

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jrms.JRMS_997_18

Background: We aimed to investigate the relationship between hemoglobin A1c (HbA1c) and coronary thrombus load in type-2 diabetes mellitus (T2DM) patients with non-ST segment elevation myocardial infarction (NSTEMI). Materials and Methods: Ninety diabetic patients with NSTEMI were recruited for the study. They were separated into two groups according to HbA1c levels. Forty-seven patients having HbA1c ≤6.5% formed Group-I (35 male, mean age 58 ± 10.5 years) and the remaining 43 patients with HbA1c >6.5% formed Group-II (23 male, mean age 58 ± 11.1 years). Both the groups were evaluated in terms of thrombolysis in myocardial infarction (TIMI) thrombus score and Syntax score. Results: Baseline patient characteristics were comparable in both the groups. TIMI thrombus score and Syntax score were higher in Group II than in Group I (3.2 ± 1.4 vs. 4.7 ± 0.5 and 20.2 ± 3.4 vs. 26.3 ± 3.0 respectively, P < 0.05). No significant difference was found in other parameters. In stepwise linear regression analysis, prepercutaneous coronary intervention (PCI) and post-PCI TIMI frame number and HbA1c were significantly related to the coronary thrombus scale. However, no significant relationship has been found between thrombus formation and hypertension, previous PCI history, pre-PCI heart rate, pre-PCI cholesterol status, and high-sensitive troponin T. Conclusion: In NSTEMI with T2DM, increased HbA1c (HbA1c >6.5%) is related with coronary thrombus in the target vessel. In those patient population, strict anticoagulation should be considered to prevent potential adverse events.

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