Why the study?
The study tested whether on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events.
Do on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events?
Do on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events?
Higher on-treatment HbA1c levels are independently associated with faster coronary atheroma progression and increased risk of MACE, supporting the importance of glycemic control.
Answers are grounded in this paper and cite their sources.
Supports tighter glycemic targets in CAD; confirms HbA1c as marker of atheroma progression and MACE risk.
BACKGROUND AND AIMS: We tested the hypothesis that on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events (MACE: death, myocardial infarction, cerebrovascular accident, coronary revascularization, or hospitalization for unstable angina) rates. METHODS: pooled analysis of data from seven prospective, randomized trials involving serial coronary intravascular ultrasonography (IVUS). The percent atheroma volume (PAV) was calculated as the proportion of the entire vessel wall occupied by atherosclerotic plaque. Using multivariable mixed modeling, we determined the association of on-treatment HbA1c with annualized change in PAV. Cox proportional hazard models were used to assess the association of HbA1c with incidence of MACE. RESULTS: 0.005]. CONCLUSIONS: Independent of achieved cardiovascular risk factor control, greater HbA1c levels significantly associate with coronary atheroma progression rates and clinical outcomes. These results support the notion of a direct, specific effect of glycemic control upon coronary atheroma and atherosclerotic events, supporting the rationale of therapies designed to directly modulate it.
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Dykun et al. (2022) studied this question.
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