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Contemporary risk estimates of three HbA1cvariables in relation to heart failure following diagnosis of type 2 diabetes

Authors :
Skrtic, Stanko
Cabrera, Claudia
Olsson, Marita
Schnecke, Volker
Lind, Marcus
Source :
Heart; 2017, Vol. 103 Issue: 5 p353-358, 6p
Publication Year :
2017

Abstract

BackgroundWe evaluated the association between glycaemic control and the risk of heart failure (HF) in a contemporary cohort of persons followed after diagnosis of type 2 diabetes (T2D).Methods and resultsPersons with T2D diagnosed between 1998 and 2012 were retrieved from the Clinical Practice Research Data Link in the UK and followed from diagnosis until the event of HF, mortality, drop out from the database due to any other reason, or the end of the study on 1 July 2015. The association between each of three different haemoglobin A1C(HbA1c) metrics and HF was estimated using adjusted proportional hazard models. In the overall cohort (n=94 332), the increased risk for HF per 1% (10 mmol/mol) increase in HbA1cwas 1.15 (95% CI 1.13 to 1.18) for updated mean HbA1c, and 1.06 (1.04 to 1.07) and 1.06 (1.04 to 1.08) for baseline HbA1cand updated latest HbA1c, respectively. When categorised, the hazard risk (HR) for the updated mean HbA1cin relation to HF became higher than for baseline and updated latest HbA1cabove HbA1clevels of 9%, but did not differ at lower HbA1clevels. The updated latest variable showed an increased risk for HbA1c<6% (42 mmol/mol) of 1.16 (1.07 to 1.25), relative category 6–7%, while the HRs for updated mean and baseline HbA1cshowed no such J-shaped pattern.ConclusionsHyperglycaemia is still a risk factor for HF in persons with T2D of similar magnitude as in earlier cohorts. Such a relationship exists for current glycaemic levels, at diagnosis and the overall level but the pattern differs for these variables.

Details

Language :
English
ISSN :
13556037 and 1468201X
Volume :
103
Issue :
5
Database :
Supplemental Index
Journal :
Heart
Publication Type :
Periodical
Accession number :
ejs41349657
Full Text :
https://doi.org/10.1136/heartjnl-2016-309806