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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Article info
Publication history
Published online: June 27, 2020
Accepted:
June 7,
2020
Received in revised form:
May 28,
2020
Received:
September 17,
2019
Identification
Copyright
© 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
