The influence of hemoglobin A1c levels on cardiovascular events and all-cause mortality in people with diabetes over 70 years of age. A prospective study
Por:
Orozco D, Navarro-Pérez J, Cebrián-Cuenca AM, Álvarez-Guisasola F, Caride-Miana E, Mora G, Quesada JA, López-Pineda A, Cardona-Llorens AF, Redón J, Gil V, Fernández A and Carratalá-Munuera C
Publicada:
1 dic 2020
Ahead of Print:
27 jun 2020
Resumen:
Aim: Glycated hemoglobin A1c (HbA1c) is a reliable risk factor of cardiovascular diseases in diabetic patients, but information about this relationship in elderly patients is scarce. The aim of this study is to analyze, the relationship between HbA1c levels and the risk of mayor adverse cardiovascular events (MACE) in patients with diabetes over 70 years.
Methods: Prospective study of subjects with diabetes using electronic health records from the universal public health system in the Valencian Community, Spain, 2008-2012. We included men and women aged >= 70 years with diabetes who underwent routine health examinations in primary care. Primary endpoint was the incidence of MACE: all-cause mortality and/or hospital admission due to coronary heart disease or stroke. A standard Cox and Cox-Aalen models were adjusted.
Results: 5016 subjects were included whit a mean age of 75.1 years (46.7% men). During an average follow-up of 49 months (4.1 years), 807 (16.1%) MACE were recorded. The incidence of MACE was 20.6 per 1000-person-years. Variables significantly associated to the incidence of MACE were male gender (HR: 1.61), heart failure (HR: 2.26), antiplatelet therapy (HR: 1.39), oral antidiabetic treatment (HR: 0.74), antithrombotics (HR: 1.79), while age, creatinine, HbA1c and peripheral arterial disease were time depend associated variables.
Conclusion: These results highlights the importance of HbA1c level in the incidence of cardiovascular events in older diabetic patients. (C) 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Orozco D:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Navarro-Pérez J:
Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain
Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Cebrián-Cuenca AM:
Cartagena Casco Health Centre, Cartagena, Murcia, Spain
Álvarez-Guisasola F:
Ribera del Órbigo Health Centre, Benavides de Órbigo, León, Spain. Electronic address:
Caride-Miana E:
Foietes Health Centre, Benidorm, Alicante, Spain
Mora G:
Los Alpes Health Centre, Madrid, Spain
Quesada JA:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Cardona-Llorens AF:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Redón J:
Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain
Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Gil V:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
Fernández A:
Biomedical Research Institute INCLIVA, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain
Ciber of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
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