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

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).

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.

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.

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.