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The association of hemoglobin a1c with incident heart failure among people without diabetes: the atherosclerosis risk in communities study.

TitleThe association of hemoglobin a1c with incident heart failure among people without diabetes: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2010
AuthorsMatsushita K, Blecker S, Pazin-Filho A, Bertoni A, Chang PP, Coresh J, Selvin E
JournalDiabetes
Volume59
Issue8
Pagination2020-6
Date Published2010 Aug
ISSN1939-327X
KeywordsAtherosclerosis, Blood Glucose, Cohort Studies, Diabetes Mellitus, Educational Status, Fasting, Female, Glycated Hemoglobin A, Heart Failure, Humans, Insulin, Male, Middle Aged, Proportional Hazards Models, Reference Values, Risk Factors, United States
Abstract

OBJECTIVE: This study sought to investigate an association of HbA1c (A1C) with incident heart failure among individuals without diabetes and compare it to fasting glucose.

RESEARCH DESIGN AND METHODS: We studied 11,057 participants of the Atherosclerosis Risk in Communities (ARIC) Study without heart failure or diabetes at baseline and estimated hazard ratios of incident heart failure by categories of A1C (

RESULTS: A total of 841 cases of incident heart failure hospitalization or deaths (International Classification of Disease, 9th/10th Revision, 428/I50) occurred during a median follow-up of 14.1 years (incidence rate 5.7 per 1,000 person-years). After the adjustment for covariates including fasting glucose, the hazard ratio of incident heart failure was higher in individuals with A1C 6.0-6.4% (1.40 [95% CI, 1.09-1.79]) and 5.5-6.0% (1.16 [0.98-1.37]) as compared with the reference group. Similar results were observed when adjusting for insulin level or limiting to heart failure cases without preceding coronary events or developed diabetes during follow-up. In contrast, elevated fasting glucose was not associated with heart failure after adjustment for covariates and A1C. Similar findings were observed when the top quartile (A1C, 5.7-6.4%, and fasting glucose, 108-125 mg/dl) was compared with the lowest quartile (

CONCLUSIONS: Elevated A1C (> or =5.5-6.0%) was associated with incident heart failure in a middle-aged population without diabetes, suggesting that chronic hyperglycemia prior to the development of diabetes contributes to development of heart failure.

DOI10.2337/db10-0165
Alternate JournalDiabetes
PubMed ID20484138
PubMed Central IDPMC2911067
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
K01 DK076595 / DK / NIDDK NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
R01 DK076770 / DK / NIDDK NIH HHS / United States
K08 HS023683 / HS / AHRQ HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
R21 DK080294 / DK / NIDDK NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States