S'abonner

Elevation of hemoglobin A1c increases the risk of decline in left ventricular systolic function among patients with coronary artery disease - 24/01/23

Doi : 10.1016/j.diabet.2022.101411 
Ziling Mai a, b, c, 1, Zhidong Huang a, b, 1, Yuqi Li d, 1, Yun Xie a, b, 1, Huanqiang Li a, b, Bo Wang a, b, Wei Bai e, Wenguang Lai a, b, Sijia Yu a, b, Hongyu Lu a, b, Kedong Han f, Xuewen Chen f, Yingming Shi f, Shiqun Chen a, b, Jin Liu a, b, , Yong Liu a, b, , Jiyan Chen a, b,
a Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China 
b Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China 
c Department of Pharmacy, Guangdong Second Provincial General Hospital, Guangdong Provincial Emergency Hospital, Guangzhou, 510317, China 
d Department of Cardiology, Zhongshan People's Hospital, Zhongshan, 528402, China 
e School of Mathematics and Statistics, School of Medicine, Guangdong University of Finance & Economics, Guangzhou, 510320, China 
f Department of Cardiology, Maoming People's Hospital, Maoming 525000, China 

Correspondence. Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular InstituteGuangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouChina

Highlights

Incidence of decline in LV systolic function increases with the elevation of HbA1c.
Elevated HbA1c is a predictor of decline in LV systolic function in CAD patients.
Decline in LV systolic function would improve the risk of cardiovascular death.

Le texte complet de cet article est disponible en PDF.

Abstract

Aims

The aim of this study was to investigate the association of HbA1c and left ventricular (LV) systolic function among patients with coronary artery disease (CAD).

Methods

CAD patients from the Cardiorenal ImprovemeNt II (CIN-II, NCT05050877) registry were included in the study. They were separated into four groups based on HbA1c levels (Q1: HbA1c<5.7%; Q2: 5.7% ≤ HbA1c < 6.1%; Q3: 6.1% ≤ HbA1c < 6.9%; Q4: HbA1c ≥ 6.9%). The endpoint was decline in LV systolic function, defined as an absolute decrease in LV ejection fraction (LVEF) ≥10% from baseline to follow-up with 3–12 months. The association of HbA1c and LVEF was assessed by logistics regression models.

Results

CAD patients (n = 3,994) (age 62.9 ± 10.6 years; 22.2% female) were included in the final analysis. A decline in LV systolic function was recorded in 429 (11%) patients during follow-up. After fully adjusting for confounders, HbA1c was significantly associated with the high risk of decline in LV systolic function (OR 1.12 [95%CI 1.05-1.20] P = 0.001). By stratifying HbA1c as four groups, there is a significantly increased risk of decline in LV systolic function when HbA1c ≥6.1% (Q2, Q3 and Q4 vs Q1, with OR 1.22 [0.88–1.68] P = 0.235; OR 1.48 [1.07–2.05] P = 0.019; OR 1.60 [1.160–2.22] P = 0.004, respectively). Meanwhile, patients with decline in LV systolic function had a higher risk of cardiovascular death.

Conclusions

Elevated HbA1c is a predictor of decline in LV systolic function in CAD patients. Clinicians should be aware of the risk of decline in LV systolic function in CAD patients with elevated HbA1c, and take measures as soon as possible.

Le texte complet de cet article est disponible en PDF.

Graphical abstract




Image, graphical abstract

Le texte complet de cet article est disponible en PDF.

Keywords : Coronary artery disease, Hemoglobin A1c, Glucose metabolism, Left ventricular ejection fraction, Left ventricular systolic function

Abbreviations : CAD, HbA1c, LVEF, AMI, HT, CKD, CHF, DM, MI, STEMI, FPG, OGTT, SGLT2i


Plan


© 2022  Publié par Elsevier Masson SAS.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 49 - N° 1

Article 101411- janvier 2023 Retour au numéro
Article précédent Article précédent
  • Physical activity and diabetes mortality in people with type 2 diabetes: a prospective cohort study of 0.5 million US people
  • Maria Reyes Beltran-Valls, Verónica Cabanas-Sánchez, Kabir P. Sadarangani, Fernando Rodríguez-Artalejo, Diego Moliner-Urdiales, David Martínez-Gómez
| Article suivant Article suivant
  • Clinical relevance of coronary risk classification and reclassification with coronary artery calcium score in asymptomatic people living with diabetes. An observational study
  • Emmanuel Cosson, Narimane Berkane, Sara Pinto, Hélène Bihan, Sopio Tatulashvili, Michael Soussan, Nicolas Sellier, Minh Tuan Nguyen, Paul Valensi

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.