HbA1c and Heart Failure Risk

The objective of the study was to investigate the race-specific association of different levels of HbA1c with the risk of HF among patients with diabetes.

Researchers prospectively investigated the race-specific association of different levels of HbA1c at baseline and during an average of 6.5 years of follow-up with incident HF risk among 17,181 African American and 12,446 White diabetic patients within the Louisiana State University (LSU) Hospital System. The main outcome measure was the incident HF.

The results showed that during follow up, 5,089 HF incident cases were identified. The multivariable-adjusted hazard ratios (HRs) of HF associated with different levels of HbA1c at baseline (<6.0% [reference group], 6.0-6.9%, 7.0-7.9%, 8.0-8.9%, 9.0-9.9%, and ≥10.0%,) were 1.00, 1.02 (95% confidence interval [CI]0.91-1.15), 1.21 (1.05-1.38), 1.29 (1.12-1.50), 1.37 (1.17-1.61), and 1.49 (1.31-1.69) (P trend<0.001) for African American diabetic patients, and 1.00, 1.09 (0.96-1.22), 1.09 (0.95-1.26), 1.43 (1.22-1.67), 1.49 (1.25-1.77), and 1.61 (1.38-1.87) (P trend<0.001) for white diabetic patients, respectively. This graded positive association was also present in diabetic patients with and without glucose-lowering agent treatment, and in diabetic patients with different age, gender, smoking status, and in incident HF defined as systolic HF (ejection fraction ≤40%) and HF with a preserved ejection fraction (ejection fraction>40%).

Researchers concluded that the current study suggests a graded positive association of HbA1c with the risk of HF among both African American and white patients with diabetes.

Zhao W, Katzmarzyk P, Horswell R, Wang Y, Johnson J, Hu G; Journal of Clinical Endocrinology & Metabolism (Dec 2013)