الفهرس 
AtherosclerosisOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is a major public health problem, the incidence of which seems to be drastically increased in the last decades.
HbA1c is not only a useful biomarker of long-term glycemic control but also a good predictor of lipid profile; thus, monitoring of glycemic control using HbA1c could have additional benefits of identifying diabetic patients who are at a greater risk of cardiovascular complications.
Coronary CT Tomography Angiography (MSCT) is a useful non-invasive tool for detecting CAD.
The aim of this work was to evaluate role of HbA1c in prediction of high risk plaque and plaque extent by MSCT.
A total of 80 diabetic patients who suffered from chest pain or dyspnea or had multiple risk factors of CAD were included in the study.
The patients were selected for the study from the Cardiology Department of Kobbry El kobba military hospital in the period between December 2016 to November 2019. Exclusion criteria 1-Patients with known CAD 2- Patients with significant valvular heart diseases 3-Patiants with contraindications to MSCT:- a) Patients with renal insufficiency (Creatinine > 1.5 mg/dl). b) Patients with dye allergy. c) Patients with any documented arrhythmia or pregnancy
4-Patients with difficulties in performing MSCT. I.e. inadequate breath holding and heart failure.
Written informed consent was taken from all participants before enrollment into the study and the study was approved by the ethical committee of Faculty of medicine Menofia University.
All included patients were subjected to the following: 1) Full history taking with special emphasis on other risk factors of CAD e.g. hypertension, dyslipidemia, smoking, family history of CAD, duration of diabetes, treatment of diabetes either insulin or oral hypoglycaemic medication, and if any associated complications. 2) Complete physical examination including vital signs, anthropometric measures, local cardiac examination, and chest auscultation. 3) Laboratory investigations including routine measures of CBC, renal functions, lipid profile and special emphasis on measures of DM including FBG, PPBG and HbA1c. 4) 12 lead ECG: for exclusion of patients with significant arrhythmias or ischemic changes. 5) Conventional Transthoracic echocardiography (TTE). 6) MSCT: - MSCT was performed with a dual-source CT (DSCT) (Siemens Somatom Definition Flash).
For each patient, the number of diseased vessels was calculated through the assignation of one, two, three, or left main (LM) coronary artery vessels. The extent and severity of CAD burden were measured by several coronary CT angiographic scores, including coronary artery calcium score (CACS), SIS, and SSS.