Elevation of hemoglobin A1c increases the risk of decline in left ventricular systolic function among patients with coronary artery disease

被引：0

作者：

Mai, Ziling ^{[1
,2
,3
]}

Huang, Zhidong ^{[1
,2
]}

Li, Yuqi ^{[4
]}

Xie, Yun ^{[1
,2
]}

Li, Huanqiang ^{[1
,2
]}

Wang, Bo ^{[1
,2
]}

Bai, Wei ^{[5
]}

Lai, Wenguang ^{[1
,2
]}

Yu, Sijia ^{[1
,2
]}

Lu, Hongyu ^{[1
,2
]}

Han, Kedong ^{[6
]}

Chen, Xuewen ^{[6
]}

Shi, Yingming ^{[6
]}

Chen, Shiqun ^{[1
,2
]}

Liu, Jin ^{[1
,2
,7
]}

Liu, Yong ^{[1
,2
,7
]}

Chen, Jiyan ^{[1
,2
,7
]}

机构：

[1] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Cardiol, Guangzhou 510080, Peoples R China

[2] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Dept Guangdong Prov Key Lab Coronary Heart Dis Pre, Guangzhou 510080, Peoples R China

[3] Guangdong Prov Emergency Hosp, Guangdong Prov Gen Hosp 2, Dept Pharm, Guangzhou 510317, Peoples R China

[4] Zhongshan Peoples Hosp, Dept Cardiol, Zhongshan 528402, Peoples R China

[5] Guangdong Univ Finance & Econ, Sch Math & Stat, Sch Med, Guangzhou 510320, Peoples R China

[6] Maoming Peoples Hosp, Dept Cardiol, Maoming 525000, Peoples R China

[7] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou, Peoples R China

来源：

DIABETES & METABOLISM | 2023年 / 49卷 / 01期

基金：

美国国家科学基金会;

关键词：

Coronary artery disease; Hemoglobin A1c; Glucose metabolism; Left ventricular ejection fraction; Left ventricular systolic function; ENDOTHELIAL-CELL; GLUCOSE; FAILURE; FIBRINOGEN; APOPTOSIS; CONSTANT; STRESS;

D O I：

10.1016/j.diabet.2022.101411

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: The aim of this study was to investigate the association of HbA1c and left ventricular (LV) systolic function among patients with coronary artery disease (CAD). Methods: CAD patients from the Cardiorenal ImprovemeNt II (CIN-II, NCT05050877) registry were included in the study. They were separated into four groups based on HbA1c levels (Q1: HbA1c<5.7%; Q2: 5.7% <= HbA1c < 6.1%; Q3: 6.1% <= HbA1c < 6.9%; Q4: HbA1c >= 6.9%). The endpoint was decline in LV systolic function, defined as an absolute decrease in LV ejection fraction (LVEF) >= 10% from baseline to follow-up with 3-12 months. The association of HbA1c and LVEF was assessed by logistics regression models. Results: CAD patients (n = 3,994) (age 62.9 +/- 10.6 years; 22.2% female) were included in the final analysis. A decline in LV systolic function was recorded in 429 (11%) patients during follow-up. After fully adjusting for confounders, HbA1c was significantly associated with the high risk of decline in LV systolic function (OR 1.12 [95%CI 1.05-1.20] P = 0.001). By stratifying HbA1c as four groups, there is a significantly increased risk of decline in LV systolic function when HbA1c >= 6.1% (Q2, Q3 and Q4 vs Q1, with OR 1.22 [0.88-1.68] P = 0.235; OR 1.48 [1.07-2.05] P = 0.019; OR 1.60 [1.160-2.22] P = 0.004, respectively). Meanwhile, patients with decline in LV systolic function had a higher risk of cardiovascular death. Conclusions: Elevated HbA1c is a predictor of decline in LV systolic function in CAD patients. Clinicians should be aware of the risk of decline in LV systolic function in CAD patients with elevated HbA1c, and take measures as soon as possible. (C) 2022 Published by Elsevier Masson SAS.

引用

页数：7