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The Hemoglobin A1c Level as a Progressive Risk Factor for Cardiovascular Death, Hospitalization for Heart Failure, or Death in Patients With Chronic Heart Failure: An Analysis of the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) Program
Abstract
BACKGROUND: A progressive relationship between hemoglobin A(1c) (HbA(1c)) levels and cardiovascular (CV) events has been observed in persons with and without diabetes. To our knowledge, the nature of such a relationship in patients with symptomatic chronic heart failure (HF) has not been studied. METHODS: A total of 2412 participants (907 with prior diabetes) in the Candesartan in Heart failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program with at least 1 HbA(1c) level were followed up for a median of 34 months. The incidence of the primary outcome (CV death or HF hospitalization), CV death, and total mortality was calculated according to eighths of the usual HbA(1c) level ranging from 5.8% or less to greater than 8.6%. Adjusted and unadjusted hazard ratios per 1% rise in HbA(1c) levels were also calculated. RESULTS: A total of 99.6% of eligible participants were followed up until they developed an outcome or the study finished. The risk of the primary composite outcome, CV death, hospitalization for worsening HF, and total mortality rose progressively with higher levels of usual HbA(1c) (P for trend <.001). After age and sex were adjusted for, hazards of these outcomes per 1% higher HbA(1c) level were 1.25 (95% confidence interval [CI ], 1.20-1.31), 1.24 (95% CI, 1.17-1.31), 1.25 (95% CI, 1.19-1.31), and 1.22 (95% CI, 1.16-1.29), respectively. This relationship was evident in patients with and without diabetes and with reduced or preserved ejection fraction and persisted after adjustment for diabetes, other risk factors, and allocation to candesartan. CONCLUSION: In diabetic and nondiabetic patients with symptomatic chronic HF, the HbA(1c) level is an independent progressive risk factor for CV death, hospitalization for HF, and total mortality.
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“In the CHARM trial, high HbA 1c was associated with increased all-cause and CV mortality in patients with T2DM and both HFrEF and HFpEF.104”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [104]
In the citing paper
“A 1% increase in HbA 1c was associated with an increased HR of 1.1 for CV mortality.104”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [104]
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Cites
Biochemistry and molecular cell biology of diabetic complications
Brownlee, M. (2001) · Nature · doi:10.1038/414813a · Cited by 9,107
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059
The Pathobiology of Diabetic Complications
Brownlee, M. (2005) · Diabetes · doi:10.2337/diabetes.54.6.1615 · Cited by 5,339
Yusuf, S., Pfeffer, M. A., Swedberg, K., Granger, C. B., Held, P., McMurray, J. J., Michelson, E. L., Olofsson, B., & Östergren, J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14285-7 · Cited by 2,994
McMurray, J. J., Östergren, J., Swedberg, K., Granger, C. B., Held, P., Michelson, E. L., Olofsson, B., Yusuf, S., & Pfeffer, M. A. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14283-3 · Cited by 2,604
Pfeffer, M. A., Swedberg, K. B., Granger, C. B., Held, P., McMurray, J. J. V., Michelson, E. L., Olofsson, B., Östergren, J., & Yusuf, S. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14282-1 · Cited by 1,895
Granger, C. B., McMurray, J. J., Yusuf, S., Held, P., Michelson, E. L., Olofsson, B., Östergren, J., Pfeffer, M. A., & Swedberg, K. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14284-5 · Cited by 1,686
Coutinho, M., Gerstein, H. C., Wang, Y., & Yusuf, S. (1999) · Diabetes Care · doi:10.2337/diacare.22.2.233 · Cited by 1,685
Self-citationMeta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus
Selvin, E., Marinopoulos, S., Berkenblit, G., Rami, T., Brancati, F. L., Powe, N. R., & Golden, S. H. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-6-200409210-00007 · Cited by 1,657
McMurray, J. J. V., Östergren, J., Swedberg, K. B., Granger, C. B., Held, P., Michelson, E. L., Olofsson, B., Yusuf, S., & Pfeffer (2003) · The Lancet · Cited by 1,043
Khaw, K.-T., Wareham, N., Bingham, S., Luben, R., Welch, A., & Day, N. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-6-200409210-00006 · Cited by 974
Renal Function as a Predictor of Outcome in a Broad Spectrum of Patients With Heart Failure
Hillege, H. L., Nitsch, D., Pfeffer, M. A., Swedberg, K., McMurray, J. J. V., Yusuf, S., Granger, C. B., Michelson, E. L., Östergren, J., Cornel, J. H., et al. (2006) · Circulation · doi:10.1161/circulationaha.105.580506 · Cited by 945
Booth, G. L., Kapral, M. K., Fung, K., & Tu, J. V. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68967-8 · Cited by 782
The DECODE Study Group, & on behalf of the European Diabetes Epidemiology Group (2003) · Diabetes Care · doi:10.2337/diacare.26.3.688 · Cited by 516
Blood glucose and risk of cardiovascular disease in the Asia Pacific region.
Asia Pacific Cohort Studies Collaboration (2004) · Diabetes Care · doi:10.2337/diacare.27.12.2836 · Cited by 302
Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes
Selvin, E., Coresh, J., Golden, S. H., Brancati, F. L., Folsom, A. R., & Steffes, M. W. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.16.1910 · Cited by 285
Gerstein, H. C., Pogue, J., Mann, J. F. E., Lonn, E., Dagenais, G. R., McQueen, M., Yusuf, S., & HOPE investigators (2005) · Diabetologia · doi:10.1007/s00125-005-1858-4 · Cited by 262
Self-citationHbA1c and Peripheral Arterial Disease in Diabetes
Selvin, E., Wattanakit, K., Steffes, M. W., Coresh, J., & Sharrett, A. R. (2006) · Diabetes Care · doi:10.2337/diacare.29.04.06.dc05-2018 · Cited by 184
Relation between blood glucose and coronary mortality over 33 years in the Whitehall Study
Brunner, E. J., Shipley, M. J., Witte, D. R., Fuller, J. H., & Marmot, M. G. (2006) · Diabetes Care · doi:10.2337/diacare.29.01.06.dc05-1405 · Cited by 166
Selvin, E., Coresh, J., Shahar, E., Zhang, L., Steffes, M. W., & Sharrett, A. R. (2005) · The Lancet Neurology · doi:10.1016/s1474-4422(05)70227-1 · Cited by 146
Khaw, K., Wareham, N. J., Bingham, S. A., & Luben, R. (2004) · ACC Current Journal Review · doi:10.1016/j.accreview.2004.11.074 · Cited by 94
Glycosylated Hemoglobin: Finally Ready for Prime Time as a Cardiovascular Risk Factor
Gerstein, H. C. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-6-200409210-00014 · Cited by 68
Self-citationGerstein, H. C., & Rosenstock, J. (2005) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2004.11.002 · Cited by 23
Self-citationRelation Between Blood Glucose and Coronary Mortality Over 33 Years in the Whitehall Study
Brunner, E. J. (2006) · Diabetes Care · doi:10.2337/diacare.29.1.26 · Cited by 18
Prevention of Cardiovascular Outcomes in Type 2 Diabetes Mellitus: Trials on the Horizon
Buse, J. B., & Rosenstock, J. (2005) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2004.11.003 · Cited by 16
Prevention of cardiovascular outcomes in type 2 diabetes mellitus: trials on the horizon
Buse, J. B., & Rosenstock, J. (2005) · Cardiology Clinics · doi:10.1016/j.ccl.2004.11.004 · Cited by 2
Reddy, K. S. (2002) · Elsevier eBooks · doi:10.1016/b978-012153654-1/50012-x · Cited by 2
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw128 · Cited by 11,429
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Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Journal of Heart Failure · doi:10.1002/ejhf.592 · Cited by 5,866
Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults
Selvin, E., Steffes, M. W., Zhu, H., Matsushita, K., Wagenknecht, L., Pankow, J., Coresh, J., & Brancati, F. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0908359 · Cited by 1,544
Long-term effects of intensive glucose lowering on cardiovascular outcomes
The ACCORD Study Group (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1006524 · Cited by 1,035
Metadata
- Authors
- Gerstein, H. C.
- Affiliations
- Population Health Research Institute (CA)
- Corresponding author
- Gerstein, Hertzel C.
- ORCID
- Gerstein, Hertzel C.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2008-08-11
- Volume
- 168
- Issue
- 15
- Pages
- 1699
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2164518074
- Cited by
- 217
- References
- 27
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 17 · 2021: 12 · 2020: 11 · 2019: 10 · 2018: 16 · 2017: 17 · 2016: 20 · 2015: 17 · 2014: 11 · 2013: 7 · 2012: 17
- FWCI
- 10.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Funders
- AstraZeneca
- Heart and Stroke Foundation of Canada
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- HbA1c, chronic heart failure, cardiovascular mortality, heart failure hospitalization, all-cause mortality, glycemic control, diabetes mellitus, candesartan, risk factors, ejection fraction
- MeSH terms
- Aged, Cardiovascular Diseases, Chronic Disease, Diabetes Mellitus, Female, Follow-Up Studies, Heart Failure, Glycated Hemoglobin, Hospitalization, Humans, Male, Risk Factors
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