AIMS/HYPOTHESIS: Although diabetes is an established risk factor for myocardial infarction (MI), disease control may vary. HbA(1c) is a reliable index of ambient glucose levels and may provide more information on MI risk than diabetes status. METHODS: The relationship between HbA(1c) levels in MI patients and controls who participated in the 52 country INTERHEART study was analysed. RESULTS: In 15,780 participants with a HbA(1c) value (1,993 of whom had diabetes), the mean (SD) levels for HbA(1c) were 6.15% (1.10) in the 6,761 MI patients and 5.85% (0.80) in the control participants. After adjustment for age, sex and nine major MI risk factors (including diabetes), higher HbA(1c) fifths above the lowest fifth (HbA(1c) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (≥ 6.12%) being 1.55 (95% CI 1.37-1.75). When analysed as a continuous variable after adjustment for the same factors, every 1% higher HbA(1c) value was associated with 19% (95% CI 14-23) higher odds of MI, while every 0.5% higher HbA(1c) was associated with 9% higher odds of MI (95% CI 7-11). Concordant relationships were noted across subgroups, with a higher OR noted in younger people, patients without diabetes or hypertension, and those from some regions and ethnicities. CONCLUSIONS/ INTERPRETATION: The HbA(1c) value provides more information on MI odds than self-reported diabetes status or many other established risk factors. Every 1% increment independently predicts a 19% higher odds of MI after accounting for other MI risk factors including diabetes.
AIMS/HYPOTHESIS: Although diabetes is an established risk factor for myocardial infarction (MI), disease control may vary. HbA(1c) is a reliable index of ambient glucose levels and may provide more information on MI risk than diabetes status. METHODS: The relationship between HbA(1c) levels in MI patients and controls who participated in the 52 country INTERHEART study was analysed. RESULTS: In 15,780 participants with a HbA(1c) value (1,993 of whom had diabetes), the mean (SD) levels for HbA(1c) were 6.15% (1.10) in the 6,761 MI patients and 5.85% (0.80) in the control participants. After adjustment for age, sex and nine major MI risk factors (including diabetes), higher HbA(1c) fifths above the lowest fifth (HbA(1c) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (≥ 6.12%) being 1.55 (95% CI 1.37-1.75). When analysed as a continuous variable after adjustment for the same factors, every 1% higher HbA(1c) value was associated with 19% (95% CI 14-23) higher odds of MI, while every 0.5% higher HbA(1c) was associated with 9% higher odds of MI (95% CI 7-11). Concordant relationships were noted across subgroups, with a higher OR noted in younger people, patients without diabetes or hypertension, and those from some regions and ethnicities. CONCLUSIONS/ INTERPRETATION: The HbA(1c) value provides more information on MI odds than self-reported diabetes status or many other established risk factors. Every 1% increment independently predicts a 19% higher odds of MI after accounting for other MI risk factors including diabetes.
Authors: Elizabeth Selvin; Josef Coresh; Sherita H Golden; Frederick L Brancati; Aaron R Folsom; Michael W Steffes Journal: Arch Intern Med Date: 2005-09-12
Authors: Elizabeth Selvin; Michael W Steffes; Hong Zhu; Kunihiro Matsushita; Lynne Wagenknecht; James Pankow; Josef Coresh; Frederick L Brancati Journal: N Engl J Med Date: 2010-03-04 Impact factor: 91.245
Authors: Robert M Califf; Mitradev Boolell; Steven M Haffner; M Angelyn Bethel; John McMurray; Anil Duggal; Rury R Holman Journal: Am Heart J Date: 2008-10 Impact factor: 4.749
Authors: Sophie V Eastwood; Therese Tillin; Naveed Sattar; Nita G Forouhi; Alun D Hughes; Nish Chaturvedi Journal: Diabetes Care Date: 2015-10-20 Impact factor: 19.112
Authors: Eva M Lonn; Jackie Bosch; Rafael Diaz; Patricio Lopez-Jaramillo; Ambady Ramachandran; Nicolae Hâncu; Markolf Hanefeld; Henry Krum; Lars Ryden; Sandra Smith; Matthew J McQueen; Leanne Dyal; Salim Yusuf; Hertzel C Gerstein Journal: Diabetes Care Date: 2013-04-05 Impact factor: 19.112
Authors: Caroline S Fox; Sherita Hill Golden; Cheryl Anderson; George A Bray; Lora E Burke; Ian H de Boer; Prakash Deedwania; Robert H Eckel; Abby G Ershow; Judith Fradkin; Silvio E Inzucchi; Mikhail Kosiborod; Robert G Nelson; Mahesh J Patel; Michael Pignone; Laurie Quinn; Philip R Schauer; Elizabeth Selvin; Dorothea K Vafiadis Journal: Diabetes Care Date: 2015-08-05 Impact factor: 19.112