1,5-Anhydro-D-glucitol predicts coronary artery disease prevalence and complexity

Background: The relationship between hemoglobin Al c (HbAlc) levels and coronary artery disease (CAD) has previously been confirmed. Serum],5-anhydro-D-glucitol (1,5-AG) levels are a useful clinical marker for short-term glycemic status that reflect glycemic excursions with greater sensitivity compared with HbAl c, specifically in the postprandial state. Postprandial hyperglycemia is an important CAD risk factor. Thus, the aim of this study was to compare HbAl c with 1,5-AG as a CAD predictor. Methods: The subjects consisted of 336 consecutive patients who underwent their first coronary angiography between July 2011 and March 2013. The relationship between CAD prevalence and HbAl c as well as CAD prevalence and 1,5-AG levels was evaluated. The correlation between CAD complexity and HbAl c or 1,5-AG was also assessed. CAD complexity was evaluated by the SYNTAX score. Results: CAD patients presented with significantly lower 1,5-AG and higher HbAl c values than patients without CAD (11.6 [mu g/ml [6.1, 19.1] vs. 17.6 mu g/m1 [11.9, 25.0], p < 0.001, and 6.0% [5.6, 7.1 vs. 5.7% [5.4, 6.21, p <0.001, respectively) (median (25th, 75th percentiles)). According to logistic regression analysis, 1,5-AG was a predictor of CAD prevalence (odds ratio 0.94,95% confidence interval 0.90-0.97). However, HbAl c levels did not present a predictive value for CAD. Levels of 1,5-AG and HbAl c were significantly correlated with SYNTAX scores (p= -0.27, p <0.001; and p= 0.23, p <0.001, respectively). Conclusions: The use of 1,5-AG, may be superior to HbAl c in predicting CAD prevalence. Both 1,5-AG and HbAl c correlate with CAD complexity. 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.