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Hemoglobin A1C Levels are Independently Associated with the Risk of Coronary Atherosclerotic Plaques in Patients without Diabetes: A Cross-Sectional Study.

  • Wang, Wei-Ting1, 2
  • Hsu, Pai-Feng1, 3, 2
  • Lin, Chung-Chi1, 2
  • Wang, Yuan-Jen1, 2
  • Ding, Yaw-Zon1, 2
  • Liou, Teh-Ling1, 2
  • Wang, Ying-Wen1, 2
  • Huang, Shao-Sung1, 3, 2
  • Lu, Tse-Min1, 3, 2
  • Huang, Po-Hsun1, 2, 4
  • Chen, Jaw-Wen3, 5, 6, 7
  • Chan, Wan-Leong1, 3, 2
  • Lin, Shing-Jong1, 3, 6, 4
  • Leu, Hsin-Bang1, 3, 2, 6, 4
  • 1 Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital.
  • 2 School of Medicine, National Yang-Ming University.
  • 3 Healthcare and Management Center, Taipei Veterans General Hospital.
  • 4 Institute of Clinical Medicine, National Yang-Ming University.
  • 5 Department of Medical Research, Taipei Veterans General Hospital.
  • 6 Cardiovascular Research Center, National Yang-Ming University.
  • 7 Institute of Pharmacology, National Yang-Ming University.
Published Article
Journal of atherosclerosis and thrombosis
Publication Date
Aug 01, 2020
DOI: 10.5551/jat.51425
PMID: 31902804


Coronary atherosclerotic plaques can be detected in asymptomatic subjects and are related to low-density lipoprotein cholesterol (LDL) levels in patients with coronary artery disease. However, researchers have not yet determined the associations between various plaque characteristics and other lipid parameters, such as HDL-C and TG levels, in low-risk populations. One thousand sixty-four non-diabetic subjects (age, 57.86±9.73 years; 752 males) who underwent coronary computed tomography angiography (CCTA) were enrolled and the severity and patterns of atherosclerotic plaques were analyzed. Statin use was reported by 25% of the study population, and subjects with greater coronary plaque involvement (segment involvement score, SIS) were older and had a higher body mass index (BMI), blood pressure, unfavorable lipid profiles and comorbidities. After adjusting for comorbidities, only age (β=0.085, p<0.001), the male gender (β=1.384, p<0.001), BMI (β=0.055, p=0.019) and HbA1C levels (β=0.894, p<0.001) were independent factors predicting the greater coronary plaque involvement in non-diabetic subjects. In the analysis of significantly different (>50%) stenosis plaque patterns, age (OR: 1.082, 95% CI: 10.47-1.118) and a former smoking status (OR: 2.061, 95% CI: 1.013-4.193) were independently associated with calcified plaques. For partial calcified (mixed type) plaques, only age (OR: 1.085, 95% CI: 1.052-1.119), the male gender (OR: 7.082, 95% CI: 2.638-19.018), HbA1C levels (OR: 2.074, 95% CI: 1.036-4.151), and current smoking status (OR: 1.848, 95% CI: 1.089-3.138) were independently associated with the risk of the presence of significant stenosis in mixed plaques. A higher HbA1c levels is independently associated with the presence and severity of coronary artery atherosclerosis in non-diabetic subjects, even when LDL-C levels are tightly controlled.

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