The Association Between HbA1c Levels and the Risk of Myocardial Infarction and Stroke in People with Type 2 Diabetes: A Post Hoc Analysis of the REPRESENT Study.

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-03-27 DOI:10.1007/s13300-025-01727-6

Irene Cristina Romera, Jennifer Redondo-Antón, Miriam Rubio-de Santos, Silvia Díaz-Cerezo, Esther Artime, Albert Rafels-Ybern, Emilio Ortega, Ignacio Conget

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引用次数: 0

Abstract

Introduction: The aim of this work was to analyze the association between baseline glycated hemoglobin (HbA1c) levels and other factors on the risk of first myocardial infarction (MI) and on the risk of first stroke in people with type 2 diabetes (T2D) in Spain.

Methods: This post hoc analysis of the REPRESENT study used the IQVIA electronic medical records database. Cumulative incidences were estimated using the Kaplan-Meier method, and Cox regression models were used to identify associated risk factors, including gender, age, HbA1c, or prior cardiovascular disease (other than MI/stroke).

Results: Median follow-up was 7 years. In people without prior MI/stroke, the incidence (95% confidence interval [CI]) of first MI/stroke was 0.31 (0.28-0.34) and 0.18 (0.15-0.20) events per 100 patient-years, respectively. Baseline HbA1c levels < 6.5% were independently associated with lower risk of first MI (hazard ratio [HR] 0.76 [95% CI 0.61-0.94]) and of first stroke (HR 0.74 [95% CI 0.56-0.98]). Male sex, age ≥ 50 years, and previous cardiovascular disease were independently associated with a higher risk of MI/stroke.

Conclusions: This analysis found an association between baseline HbA1c levels < 6.5% and lower risk of a first MI or stroke in a T2D cohort in Spain, suggesting a role of stringent glycemic control in the prevention of cardiovascular complications.

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2型糖尿病患者HbA1c水平与心肌梗死和卒中风险之间的关系：一项代表研究的事后分析

本研究的目的是分析基线糖化血红蛋白（HbA1c）水平和其他因素与西班牙2型糖尿病（T2D）患者首次心肌梗死（MI）风险和首次卒中风险之间的关系。方法：使用IQVIA电子病历数据库对代表研究进行事后分析。使用Kaplan-Meier方法估计累积发病率，并使用Cox回归模型确定相关危险因素，包括性别、年龄、HbA1c或既往心血管疾病（心肌梗死/卒中除外）。结果：中位随访时间为7年。在既往无心肌梗死/卒中的人群中，首次心肌梗死/卒中的发生率（95%置信区间[CI]）分别为0.31（0.28-0.34）和0.18(0.15-0.20)/ 100患者年。结论：该分析发现基线HbA1c水平之间存在关联

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.