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The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study
OBJECTIVE: This study sought to investigate an association of HbA1c (A1C) with incident heart failure among individuals without diabetes and compare it to fasting glucose. RESEARCH DESIGN AND METHODS: We studied 11,057 participants of the Atherosclerosis Risk in Communities (ARIC) Study without hear...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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American Diabetes Association
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/ https://www.ncbi.nlm.nih.gov/pubmed/20484138 http://dx.doi.org/10.2337/db10-0165 |
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author | Matsushita, Kunihiro Blecker, Saul Pazin-Filho, Antonio Bertoni, Alain Chang, Patricia P. Coresh, Josef Selvin, Elizabeth |
author_facet | Matsushita, Kunihiro Blecker, Saul Pazin-Filho, Antonio Bertoni, Alain Chang, Patricia P. Coresh, Josef Selvin, Elizabeth |
author_sort | Matsushita, Kunihiro |
collection | PubMed |
description | OBJECTIVE: This study sought to investigate an association of HbA1c (A1C) with incident heart failure among individuals without diabetes and compare it to fasting glucose. RESEARCH DESIGN AND METHODS: We studied 11,057 participants of the Atherosclerosis Risk in Communities (ARIC) Study without heart failure or diabetes at baseline and estimated hazard ratios of incident heart failure by categories of A1C (<5.0, 5.0–5.4 [reference], 5.5–5.9, and 6.0–6.4%) and fasting glucose (<90, 90–99 [reference], 100–109, and 110–125 mg/dl) using Cox proportional hazards models. RESULTS: A total of 841 cases of incident heart failure hospitalization or deaths (International Classification of Disease, 9th/10th Revision, 428/I50) occurred during a median follow-up of 14.1 years (incidence rate 5.7 per 1,000 person-years). After the adjustment for covariates including fasting glucose, the hazard ratio of incident heart failure was higher in individuals with A1C 6.0–6.4% (1.40 [95% CI, 1.09–1.79]) and 5.5–6.0% (1.16 [0.98–1.37]) as compared with the reference group. Similar results were observed when adjusting for insulin level or limiting to heart failure cases without preceding coronary events or developed diabetes during follow-up. In contrast, elevated fasting glucose was not associated with heart failure after adjustment for covariates and A1C. Similar findings were observed when the top quartile (A1C, 5.7–6.4%, and fasting glucose, 108–125 mg/dl) was compared with the lowest quartile (<5.2% and <95 mg/dl, respectively). CONCLUSIONS: Elevated A1C (≥5.5–6.0%) was associated with incident heart failure in a middle-aged population without diabetes, suggesting that chronic hyperglycemia prior to the development of diabetes contributes to development of heart failure. |
format | Text |
id | pubmed-2911067 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-29110672011-08-01 The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study Matsushita, Kunihiro Blecker, Saul Pazin-Filho, Antonio Bertoni, Alain Chang, Patricia P. Coresh, Josef Selvin, Elizabeth Diabetes Complications OBJECTIVE: This study sought to investigate an association of HbA1c (A1C) with incident heart failure among individuals without diabetes and compare it to fasting glucose. RESEARCH DESIGN AND METHODS: We studied 11,057 participants of the Atherosclerosis Risk in Communities (ARIC) Study without heart failure or diabetes at baseline and estimated hazard ratios of incident heart failure by categories of A1C (<5.0, 5.0–5.4 [reference], 5.5–5.9, and 6.0–6.4%) and fasting glucose (<90, 90–99 [reference], 100–109, and 110–125 mg/dl) using Cox proportional hazards models. RESULTS: A total of 841 cases of incident heart failure hospitalization or deaths (International Classification of Disease, 9th/10th Revision, 428/I50) occurred during a median follow-up of 14.1 years (incidence rate 5.7 per 1,000 person-years). After the adjustment for covariates including fasting glucose, the hazard ratio of incident heart failure was higher in individuals with A1C 6.0–6.4% (1.40 [95% CI, 1.09–1.79]) and 5.5–6.0% (1.16 [0.98–1.37]) as compared with the reference group. Similar results were observed when adjusting for insulin level or limiting to heart failure cases without preceding coronary events or developed diabetes during follow-up. In contrast, elevated fasting glucose was not associated with heart failure after adjustment for covariates and A1C. Similar findings were observed when the top quartile (A1C, 5.7–6.4%, and fasting glucose, 108–125 mg/dl) was compared with the lowest quartile (<5.2% and <95 mg/dl, respectively). CONCLUSIONS: Elevated A1C (≥5.5–6.0%) was associated with incident heart failure in a middle-aged population without diabetes, suggesting that chronic hyperglycemia prior to the development of diabetes contributes to development of heart failure. American Diabetes Association 2010-08 2010-05-18 /pmc/articles/PMC2911067/ /pubmed/20484138 http://dx.doi.org/10.2337/db10-0165 Text en © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Complications Matsushita, Kunihiro Blecker, Saul Pazin-Filho, Antonio Bertoni, Alain Chang, Patricia P. Coresh, Josef Selvin, Elizabeth The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title | The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title_full | The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title_fullStr | The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title_full_unstemmed | The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title_short | The Association of Hemoglobin A1c With Incident Heart Failure Among People Without Diabetes: The Atherosclerosis Risk in Communities Study |
title_sort | association of hemoglobin a1c with incident heart failure among people without diabetes: the atherosclerosis risk in communities study |
topic | Complications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/ https://www.ncbi.nlm.nih.gov/pubmed/20484138 http://dx.doi.org/10.2337/db10-0165 |
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