Article written by Bruce Sylvester
Glycated hemoglobin A1c (HbA1c) greater than 7% correlates with an increased risk of cardiovascular events in elderly patients..
..researchers reported on July 22, 2020 in Primary Care Diabetes.
As background to the study, the investigators noted that elevated glycated hemoglobin A1c (HbA1c) is a known risk factor for cardiovascular disease in diabetic patients. But there has been little specific information about this matter in elderly patients (those over 70 years).
“The aim of this study is to analyze, the relationship between HbA1c levels and the risk of major adverse cardiovascular events (MACE) in patients with diabetes over 70 years,” they said.
They designed this study as a prospective study of diabetic subjects using electronic health records from the universal public health system in the Valencian Community, Spain, 2008–2012.
They enrolled men and women aged ≥ 70 years with diagnosed diabetes (HbA1c greater than 7%) who had health examinations in a primary care setting.
The endpoints were incidence of major adverse cardiovascular events (MACE), all-cause mortality and/or hospital admission due to coronary heart disease or stroke.
They analyzed data from 5,016 subjects with a mean age of 75.1 years (46.7% men).
During an average follow-up of 49 months (4.1 years), they reported 807 (16.1%) incidents of MACE.
The incidence of MACE was 20.6 per 1000-person-years.
Significantly associated with MACE were male gender (HR: 1.61, 61% elevated risk), heart failure (HR: 2.26, 126% elevated risk), antiplatelet therapy (HR: 1.39, 39% elevated risk ), oral antidiabetic treatment (HR: 0.74, 26% reduced risk), anti-thrombotics (HR: 1.79, 79% elevated risk).
“These results highlight the importance of HbA1c level in the incidence of cardiovascular events in older diabetic patients,” the authors concluded.