Relation of glycated hemoglobin with carotid atherosclerosis in ischemic stroke patients: An observational study in Indian population

CONTEXT: Glycated hemoglobin A(1)c(HbA(1)c) indicates long-term uncontrolled hyperglycemia in the body, which in diabetic patients leads to various vascular complications as a part of generalized atherosclerosis culminating ultimately into ischemic stroke. AIMS: Study aims to show the association between marker of uncontrolled long-term hyperglycemia HbA(1)c and marker of atherosclerosis (Carotid intima media thickness [CIMT] and carotid plaque) in ischemic stroke patients. SUBJECTS AND METHODS: Carotid sonography using high resolution 7.5 MHz sonography technique was done in each patient to find the occurrence of increased CIMT and presence of plaque according to Mannheim CIMT Consensus (2004-2006). Levels of HbA(1)c measured in blood in both diabetic and non-diabetic patients and a comparison made between them. Finally an association sought between HbA(1)c levels with CIMT and plaque. RESULTS: The average value of HbA(1)c of this cohort was 7.51 ± 1.75% with higher values in diabetic patients (9.29 ± 1.73%). The patients with high CIMT (>0.8 mm) had higher values of HbA(1)c then that of normal CIMT patients and this was nearly significantly (P = 0.06). However, HbA(1)c levels of blood were significantly associated with stroke patients with presence of carotid arteries plaque (P = 0.008). CONCLUSIONS: Prediction of future risk and prevention strategies for ischemic stroke could be formulated by utilizing HbA(1)c levels in both diabetic and non-diabetic population.