Evaluation of the Relationship Between Coronary Artery Disease Complexity and Metabolic and Hormonal Parameters in Non-Diabetic Patients with Acute Coronary Syndrome

Evaluation of the Relationship Between Coronary Artery Disease Complexity and Metabolic and Hormonal Parameters in Non-Diabetic Patients with Acute Coronary Syndrome | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of the Relationship Between Coronary Artery Disease Complexity and Metabolic and Hormonal Parameters in Non-Diabetic Patients with Acute Coronary Syndrome Mehmet şeker, Ömer Işık, Esra Polat, Cengiz Şabanoğlu, Mustafa Necati Dağlı This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8050190/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 May, 2026 Read the published version in BMC Cardiovascular Disorders → Version 1 posted 19 You are reading this latest preprint version Abstract Introduction: Despite long-standing research on the relationship between coronary artery disease complexity and metabolic and hormonal parameters, the number of studies focusing on non-diabetic patients, a key subgroup of this disease, has remained limited. This study aims to investigate the relationship between specific metabolic and hormonal markers and disease complexity in non-diabetic patients with coronary artery disease. This work is intended to contribute to a growing body of literature, supporting the accelerating trend in research rather than the previously observed plateau. Materials and Methods Between January 2021 and December 2024, patients hospitalized with acute coronary syndrome and undergoing coronary angiography were retrospectively screened based on their medical records and laboratory data (blood tests obtained after fasting for at least 12 hours). Patients were categorized into two groups: those with a diagnosis of diabetes and those without. A relationship analysis was performed between the two groups based on HbA1c levels (HbA1c ≥ 6.5% and HbA1c < 6.5%). Additionally, an analysis of the SYNTAX score and its components was conducted to investigate the association between coronary artery disease complexity and various metabolic and hormonal parameters in non-diabetic patients with acute coronary syndrome by identifying correlations differing from those observed in the diabetic group. Results Among the 636 study participants, the mean HbA1c level was 6.34 ± 1.38. Of these patients, 65% (n = 416) had HbA1c levels of 6.4% or below, while 35% (n = 220) had levels of 6.5% or above. Pearson correlation analysis was used to evaluate the relationships between the SYNTAX score and clinical and biochemical variables. The SYNTAX score demonstrated a positive and statistically significant correlation with HbA1c (r = 0.192, p < 0.05), age (r = 0.163, p < 0.05), and serum uric acid (SUA) (r = 0.135, p < 0.05). In the group with HbA1c levels < 6.5%, there was a positive correlation between the SYNTAX score and HbA1c, age, and serum uric acid, while a negative correlation was observed with thyroid-stimulating hormone (TSH). In contrast, in the group with HbA1c levels ≥ 6.5%, the SYNTAX score showed a positive correlation only with age (r = 0.164, p < 0.05), and no significant correlations were observed with other parameters. Conclusion TSH and serum uric acid (SUA) levels were independently associated with the severity of coronary artery disease, particularly in the non-diabetic subgroup of patients with obstructive coronary artery disease. These findings may support more accurate risk stratification in clinical practice and facilitate the development of tailored approaches for each coronary artery disease subgroup by identifying potential new target parameters. Non-diabetic coronary artery disease acute coronary syndrome SYNTAX elevated serum uric acid thyroid-stimulating hormone Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 02 May, 2026 Read the published version in BMC Cardiovascular Disorders → Version 1 posted Editorial decision: Revision requested 30 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviews received at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviews received at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviews received at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers agreed at journal 05 Dec, 2025 Reviewers invited by journal 02 Dec, 2025 Editor invited by journal 01 Dec, 2025 Editor assigned by journal 29 Nov, 2025 Submission checks completed at journal 29 Nov, 2025 First submitted to journal 06 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8050190","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":554257802,"identity":"a2d860e6-e277-43ae-b02c-c04d71ada11f","order_by":0,"name":"Mehmet şeker","email":"","orcid":"","institution":"Department of Cardiology, Ümraniye Training and Research Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"şeker","suffix":""},{"id":554257804,"identity":"8d483215-3e92-46ee-a46c-f2f0c9377657","order_by":1,"name":"Ömer 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Syndrome","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Non-diabetic, coronary artery disease, acute coronary syndrome, SYNTAX, elevated serum uric acid, thyroid-stimulating hormone","lastPublishedDoi":"10.21203/rs.3.rs-8050190/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8050190/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e\u003cp\u003eDespite long-standing research on the relationship between coronary artery disease complexity and metabolic and hormonal parameters, the number of studies focusing on non-diabetic patients, a key subgroup of this disease, has remained limited. This study aims to investigate the relationship between specific metabolic and hormonal markers and disease complexity in non-diabetic patients with coronary artery disease. This work is intended to contribute to a growing body of literature, supporting the accelerating trend in research rather than the previously observed plateau.\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e\u003cp\u003eBetween January 2021 and December 2024, patients hospitalized with acute coronary syndrome and undergoing coronary angiography were retrospectively screened based on their medical records and laboratory data (blood tests obtained after fasting for at least 12 hours). Patients were categorized into two groups: those with a diagnosis of diabetes and those without. A relationship analysis was performed between the two groups based on HbA1c levels (HbA1c\u0026thinsp;\u0026ge;\u0026thinsp;6.5% and HbA1c\u0026thinsp;\u0026lt;\u0026thinsp;6.5%). Additionally, an analysis of the SYNTAX score and its components was conducted to investigate the association between coronary artery disease complexity and various metabolic and hormonal parameters in non-diabetic patients with acute coronary syndrome by identifying correlations differing from those observed in the diabetic group.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAmong the 636 study participants, the mean HbA1c level was 6.34\u0026thinsp;\u0026plusmn;\u0026thinsp;1.38. Of these patients, 65% (n\u0026thinsp;=\u0026thinsp;416) had HbA1c levels of 6.4% or below, while 35% (n\u0026thinsp;=\u0026thinsp;220) had levels of 6.5% or above. Pearson correlation analysis was used to evaluate the relationships between the SYNTAX score and clinical and biochemical variables. The SYNTAX score demonstrated a positive and statistically significant correlation with HbA1c (r\u0026thinsp;=\u0026thinsp;0.192, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), age (r\u0026thinsp;=\u0026thinsp;0.163, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and serum uric acid (SUA) (r\u0026thinsp;=\u0026thinsp;0.135, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In the group with HbA1c levels\u0026thinsp;\u0026lt;\u0026thinsp;6.5%, there was a positive correlation between the SYNTAX score and HbA1c, age, and serum uric acid, while a negative correlation was observed with thyroid-stimulating hormone (TSH). In contrast, in the group with HbA1c levels\u0026thinsp;\u0026ge;\u0026thinsp;6.5%, the SYNTAX score showed a positive correlation only with age (r\u0026thinsp;=\u0026thinsp;0.164, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and no significant correlations were observed with other parameters.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eTSH and serum uric acid (SUA) levels were independently associated with the severity of coronary artery disease, particularly in the non-diabetic subgroup of patients with obstructive coronary artery disease. These findings may support more accurate risk stratification in clinical practice and facilitate the development of tailored approaches for each coronary artery disease subgroup by identifying potential new target parameters.\u003c/p\u003e","manuscriptTitle":"Evaluation of the Relationship Between Coronary Artery Disease Complexity and Metabolic and Hormonal Parameters in Non-Diabetic Patients with Acute Coronary Syndrome","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-04 17:44:13","doi":"10.21203/rs.3.rs-8050190/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-30T06:58:19+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"52554692305459992061323633748762650419","date":"2026-01-29T22:31:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-29T19:25:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"307528038777916839614821510759241236240","date":"2026-01-29T19:04:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-29T17:50:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"142087617404739337310317641299551761712","date":"2026-01-29T17:36:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17608516748527221219716968797723334047","date":"2026-01-29T17:15:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144539241975650842758628966691412204581","date":"2026-01-29T16:59:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155124570912562620863678057417012038466","date":"2026-01-29T16:23:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-29T16:13:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"199634587330265362853039252741118433678","date":"2026-01-29T15:58:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"73403271820200860761087116072542175277","date":"2026-01-29T15:56:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9558994167401739044566283568500623963","date":"2026-01-29T15:55:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27706048400230688041540136721970854349","date":"2025-12-05T09:38:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-02T16:06:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-01T15:53:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-29T13:15:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-29T13:14:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cardiovascular Disorders","date":"2025-11-06T16:48:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cardiovascular-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcar","sideBox":"Learn more about [BMC Cardiovascular Disorders](http://bmccardiovascdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcar/default.aspx","title":"BMC Cardiovascular Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"675e1210-c45a-4675-ac5d-e1f3e895159a","owner":[],"postedDate":"December 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T15:11:46+00:00","versionOfRecord":{"articleIdentity":"rs-8050190","link":"https://doi.org/10.1186/s12872-026-05792-y","journal":{"identity":"bmc-cardiovascular-disorders","isVorOnly":false,"title":"BMC Cardiovascular Disorders"},"publishedOn":"2026-05-02 15:57:10","publishedOnDateReadable":"May 2nd, 2026"},"versionCreatedAt":"2025-12-04 17:44:13","video":"","vorDoi":"10.1186/s12872-026-05792-y","vorDoiUrl":"https://doi.org/10.1186/s12872-026-05792-y","workflowStages":[]},"version":"v1","identity":"rs-8050190","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8050190","identity":"rs-8050190","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}