Key result
Each 1% higher baseline A1C was associated with an 11% increased risk of heart failure hospitalization or cardiovascular death (HR 1.11) independently of left ventricular ejection fraction.
Why the study?
Chronic hyperglycaemia is a known risk factor for HF and CV death in diabetes, but whether this risk varies with LVEF is unknown.
Does elevated baseline A1C increase the risk of heart failure hospitalization or cardiovascular death across the spectrum of LVEF in patients with type 2 diabetes and a recent acute coronary syndrome?
Cohort (n=4,091)
Yes
Does elevated baseline A1C increase the risk of heart failure hospitalization or cardiovascular death across the spectrum of LVEF in patients with type 2 diabetes and a recent acute coronary syndrome?
Hazard Ratio: 1.11 (95% CI 1.01–1.21)
p-value: p=0.023
In patients with type 2 diabetes and recent acute coronary syndrome, higher baseline A1C and lower LVEF are independently and incrementally associated with an increased risk of heart failure hospitalization or cardiovascular death.
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Higher A1C may aid risk stratification post-ACS across LVEF; leaves open whether glycemic control reduces HF events.
Shin et al. (2020) conducted a cohort in Type 2 diabetes and recent acute coronary syndrome (n=4,091). Baseline A1C (per 1% increase) vs. Lower A1C was evaluated on Composite of first occurrence of either hospitalization for heart failure or cardiovascular death (HR 1.11, 95% CI 1.01-1.21, p=0.023). Each 1% higher baseline A1C was associated with an 11% increased risk of heart failure hospitalization or cardiovascular death (HR 1.11) independently of left ventricular ejection fraction.
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