Domingo Orozco-Beltrán1, Jorge Navarro-Pérez2, Ana M Cebrián-Cuenca3, Fernando Álvarez-Guisasola4, Elena Caride-Miana5, Gustavo Mora6, José A Quesada7, Adriana López-Pineda8, Antonio F Cardona-Llorens9, Josep Redón10, Vicente F Gil-Guillen11, Antonio Fernández12, Concepción Carratalá-Munuera13. 1. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: dorozco@umh.es. 2. Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain; Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: jorgenavper@gmail.com. 3. Cartagena Casco Health Centre, Cartagena, Murcia, Spain. Electronic address: anicebrian@gmail.com. 4. Ribera del Órbigo Health Centre, Benavides de Órbigo, León, Spain. Electronic address: f.a.guisasola@gmail.com. 5. Foietes Health Centre, Benidorm, Alicante, Spain. Electronic address: e.carid@gmail.com. 6. Los Alpes Health Centre, Madrid, Spain. Electronic address: gus.mora@icloud.com. 7. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: jquesada@umh.es. 8. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: adriannalp@hotmail.com. 9. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: antonio.cardona@umh.es. 10. Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain; Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: josep.redon@uv.es. 11. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: vte.gil@gmail.com. 12. Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain; Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: tonifdz@yahoo.es. 13. Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain. Electronic address: maria.carratala@umh.es.
Abstract
AIM: Glycated hemoglobin A1c (HbA1c) is a reliable risk factor of cardiovascular diseases in diabetic patients, but information about this relationship in elderly patients is scarce. The aim of this study is to analyze, the relationship between HbA1c levels and the risk of mayor adverse cardiovascular events (MACE) in patients with diabetes over 70 years. METHODS: Prospective study of subjects with diabetes using electronic health records from the universal public health system in the Valencian Community, Spain, 2008-2012. We included men and women aged≥70 years with diabetes who underwent routine health examinations in primary care. Primary endpoint was the incidence of MACE: all-cause mortality and/or hospital admission due to coronary heart disease or stroke. A standard Cox and Cox-Aalen models were adjusted. RESULTS: 5016 subjects were included whit a mean age of 75.1 years (46.7% men). During an average follow-up of 49 months (4.1 years), 807 (16.1%) MACE were recorded. The incidence of MACE was 20.6 per 1000-person-years. Variables significantly associated to the incidence of MACE were male gender (HR: 1.61), heart failure (HR: 2.26), antiplatelet therapy (HR: 1.39), oral antidiabetic treatment (HR: 0.74), antithrombotics (HR: 1.79), while age, creatinine, HbA1c and peripheral arterial disease were time-depend associated variables. CONCLUSION: These results highlights the importance of HbA1c level in the incidence of cardiovascular events in older diabetic patients.
AIM: Glycated hemoglobin A1c (HbA1c) is a reliable risk factor of cardiovascular diseases in diabeticpatients, but information about this relationship in elderly patients is scarce. The aim of this study is to analyze, the relationship between HbA1c levels and the risk of mayor adverse cardiovascular events (MACE) in patients with diabetes over 70 years. METHODS: Prospective study of subjects with diabetes using electronic health records from the universal public health system in the Valencian Community, Spain, 2008-2012. We included men and women aged≥70 years with diabetes who underwent routine health examinations in primary care. Primary endpoint was the incidence of MACE: all-cause mortality and/or hospital admission due to coronary heart disease or stroke. A standard Cox and Cox-Aalen models were adjusted. RESULTS: 5016 subjects were included whit a mean age of 75.1 years (46.7% men). During an average follow-up of 49 months (4.1 years), 807 (16.1%) MACE were recorded. The incidence of MACE was 20.6 per 1000-person-years. Variables significantly associated to the incidence of MACE were male gender (HR: 1.61), heart failure (HR: 2.26), antiplatelet therapy (HR: 1.39), oral antidiabetic treatment (HR: 0.74), antithrombotics (HR: 1.79), while age, creatinine, HbA1c and peripheral arterial disease were time-depend associated variables. CONCLUSION: These results highlights the importance of HbA1c level in the incidence of cardiovascular events in older diabeticpatients.
Authors: Sharen Lee; Jiandong Zhou; Keith Sai Kit Leung; William Ka Kei Wu; Wing Tak Wong; Tong Liu; Ian Chi Kei Wong; Kamalan Jeevaratnam; Qingpeng Zhang; Gary Tse Journal: BMJ Open Diabetes Res Care Date: 2021-06