Glycated Albumin (GA) is a medium-term glycemic marker more sensitive to fluctuations in glucose and is unagaffected by factors which affect the lifespan of erythrocytes. Several studies have assessed whether GA has better predictive value or could complement HbA1c for the presence, severity, and prognosis of coronary artery disease (CAD). However, the data remain indefinite. This study compares the efficacy of GA and HbA1c as predictors of the presence, severity, and outcomes of coronary artery disease from recent literature evidence. A systematic review was performed on observational studies, cohort, and cross-sectional studies that reported the association between GA and/or HbA1c with CAD, considering data from PubMed. Studies which evaluated the severity of CAD using angiography/scoring systems like SYNTAX and Gensini, which compared GA and HbA1c, and were related to adults, were included in this review. Various studies reported that GA exhibits a significant association with the severity of coronary stenosis as compared to HbA1c. Furthermore, GA can even observe glycemic fluctuations over a short period, but HbA1c remains valid as a long-term measure. A dual approach may enhance the accuracy in determining cardiovascular risk, particularly in patients with diabetes. In summary, these studies demonstrated that GA outperformed HbA1c in identifying the severity and risk associated with CAD, and when combined, could provide a more robust measure of cardiovascular risk.
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