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Research Article| Volume 14, ISSUE 6, P678-684, December 2020

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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

      Highlights

      • Information about HbA1c and cardiovascular disease in elderly patients is scarce.
      • The incidence of events in patients ≥ 70 years was 20.6 per 1000/person/year.
      • HbA1c > 7% is associated with cardiovascular events in elderly patients.

      Abstract

      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.

      Keywords

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      2. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Available from: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statisticsreport.pdf (accessed 16.09.19).

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