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    Advantages and pitfalls of the glycated hemoglobin A1c measurement in acute coronary syndrome: Start simple, evolve to more sophisticated
    (SAGE Publications Inc., 2019) Karakurt, Mustafa; Açar, Burak; Özeke, Özcan; Özbay, Mustafa Bilal; Özen, Yasin; Karanfil, Mustafa; Ünal, Sefa; Yayla, Çağrı; Çay, Serkan; Maden, Orhan; Aras, Dursun; Topaloğlu, Serkan; Aydoğdu, Sinan; Gölbaşı, Zehra
    We would like to thank Cetin et al1 for their interest in our work titled, “Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome”2 about the association of prediabetes with higher coronary atherosclerotic burden among patients with first diagnosed acute coronary syndrome (ACS). Cetin et al reported some concerns about the categorization of the study population using only glycated hemoglobin (HbA1c) level might be misleading and especially overdiagnosing prediabetic population.
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    Association of prediabetes with higher coronary atherosclerotic burden among patients with first diagnosed acute coronary syndrome
    (SAGE Publications Inc., 2019) Açar, Burak; Özeke, Özcan; Karakurt, Mustafa; Özen, Yasin; Özbay, Mustafa Bilal; Ünal, Sefa; Karanfil, Mustafa; Yayla, Çağrı; Çay, Serkan; Maden, Orhan; Topaloğlu, Serkan; Aras, Dursun; Gölbaşı, Zehra; Aydoğdu, Sinan
    Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients (P =.004, P =.008, and P =.014, respectively), but similar in prediabetic and diabetic patients (P =.912, P =.773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS. © The Author(s) 2018.

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