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High HbA1c Variability and Risk of MACE

Diabetes Care; ePub 2018 Oct 23; Ghouse, et al

Publish date:: November 6, 2018

High glycated hemoglobin A_1c (HbA_1c) variability was associated with increased risks of major adverse cardiovascular events (MACE) and all-cause mortality in a primary care population free of diabetes and cardiovascular disease (CVD), a new study found. Patients with 3 annual HbA_1c measurements within normal range were included. Associations between HbA_1c variability and outcome were analyzed using Cox regression, adjusted for traditional risk factors, intercept, and trends, and reported as hazard ratio per SD increase in variability (HR_SD). Among the findings:

6,756 individuals were included in the study.
996 individuals developed MACE, 856 died, and 1,267 developed type 2 diabetes (T2D) during median follow-up of 6.3 years.
There was a significant association between increasing HbA_1c variability and incident MACE (HR_SD 1.09) and all-cause mortality (HR_SD 1.00).
Clinically relevant differences were found across several age, sex, and comorbidity subgroups in calculating 5-year absolute risks of MACE and all-cause mortality.

Citation:

Ghouse J, Skov MW, Kanters JK, et al. Visit-to-visit variability of hemoglobin A1c in people without diabetes and risk of major adverse cardiovascular events and all-cause mortality. [Published online ahead of print October 23, 2018]. Diabetes Care. doi:10.2337/dc18-1396.

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