TY - JOUR
T1 - Hemoglobin A1c predicts heart failure hospitalization independent of baseline cardiac function or B-type natriuretic peptide level
AU - Kishimoto, Ichiro
AU - Makino, Hisashi
AU - Ohata, Yoko
AU - Tamanaha, Tamiko
AU - Tochiya, Mayu
AU - Kada, Akiko
AU - Ishihara, Masaharu
AU - Anzai, Toshihisa
AU - Shimizu, Wataru
AU - Yasuda, Satoshi
AU - Ogawa, Hisao
PY - 2014/5
Y1 - 2014/5
N2 - Aims: Diabetes is a major risk factor for heart failure (HF). We examined whether baseline HbA1c level predicts HF incidence independent of other HF risk factors, including baseline cardiac structural and functional abnormalities. Methods: In patients with type 2 diabetes, multivariable Cox regression models were constructed to examine the independent association between baseline HbA1c and future HF hospitalization. Results: In 608 subjects (mean age, 66.5 years; men, 68%; mean HbA1c, 9.1% (76mmol/mol)), 92 were hospitalized for HF during a median follow-up of 6 years. For a 1% (11mmol/mol) increase in baseline HbA1c, the hazard ratio for HF was 1.23 (95% confidence interval, 1.1-1.7, p<0.001) with adjustment for age, sex, body mass index, blood pressure and plasma B-type natriuretic peptide (BNP) level. The effect of HbA1c on HF was independent of baseline left ventricular (LV) ejection fraction, the ratio of peak early to late diastolic filling velocity, and prevalent/incident coronary heart disease (CHD), and was more evident in patients with enlarged LV, decreased systolic function, prevalent CHD, or prevalent HF. Conclusion: In patients with type 2 diabetes, HbA1c significantly predicts future HF hospitalization independent of baseline BNP level or echocardiographic parameters.
AB - Aims: Diabetes is a major risk factor for heart failure (HF). We examined whether baseline HbA1c level predicts HF incidence independent of other HF risk factors, including baseline cardiac structural and functional abnormalities. Methods: In patients with type 2 diabetes, multivariable Cox regression models were constructed to examine the independent association between baseline HbA1c and future HF hospitalization. Results: In 608 subjects (mean age, 66.5 years; men, 68%; mean HbA1c, 9.1% (76mmol/mol)), 92 were hospitalized for HF during a median follow-up of 6 years. For a 1% (11mmol/mol) increase in baseline HbA1c, the hazard ratio for HF was 1.23 (95% confidence interval, 1.1-1.7, p<0.001) with adjustment for age, sex, body mass index, blood pressure and plasma B-type natriuretic peptide (BNP) level. The effect of HbA1c on HF was independent of baseline left ventricular (LV) ejection fraction, the ratio of peak early to late diastolic filling velocity, and prevalent/incident coronary heart disease (CHD), and was more evident in patients with enlarged LV, decreased systolic function, prevalent CHD, or prevalent HF. Conclusion: In patients with type 2 diabetes, HbA1c significantly predicts future HF hospitalization independent of baseline BNP level or echocardiographic parameters.
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U2 - 10.1016/j.diabres.2014.02.009
DO - 10.1016/j.diabres.2014.02.009
M3 - Article
C2 - 24629410
AN - SCOPUS:84898833180
SN - 0168-8227
VL - 104
SP - 257
EP - 265
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 2
ER -
