Dataset Information

Change in HbA1c over 3 years does not improve the prediction of cardiovascular disease over and above HbA1c measured at a single time point.

ABSTRACT:

Aims/hypothesis

HbA1c is an important risk factor for cardiovascular disease (CVD), with 1% higher HbA1c levels associated with a 10-20% increased risk of CVD. Little is known about the association between change in HbA1c over time and cardiovascular risk in non-diabetic populations. This study examined the association between change in HbA1c over time and cardiovascular risk in a non-diabetic British population.

Methods

We used data on HbA1c collected at baseline and at a second health examination 3 years later among a population of 5,790 non-diabetic men and women who participated in the European Prospective Investigation of Cancer (EPIC)-Norfolk. The association between change in HbA1c over 3 years and incident cardiovascular events over the following 8 years was examined using multivariate Cox regression. We also examined whether information on change in HbA1c over time improved prediction of cardiovascular events over a single measure of HbA1c by comparing the area under the receiver operating characteristic curves (aROC) and computing the net reclassification improvement.

Results

The mean change (SD) in HbA1c over 3 years was 0.13% (0.52). During 44,596 person-years of follow-up, 529 cardiovascular events occurred (incidence 11.9 per 1,000 person-years). Each 0.5% rise in HbA1c over 3 years was associated with a 9% increase in risk of a cardiovascular event (HR 1.09; 95% CI 1.01, 1.18) after adjustment for baseline HbA1c and other major cardiovascular risk factors. However, change in HbA1c was not associated with cardiovascular risk after adjustment for HbA1c at follow-up. Multivariate models with and without information on change in HbA1c over time showed a similar aROC of 0.78. Adding change in HbA1c to the model with HbA1c at follow-up did not improve risk classification.

Conclusions/interpretation

Addition of information on change in HbA1c over 3 years did not improve the prediction of CVD over and above information on HbA1c and other major cardiovascular risk factors from a single time point.

SUBMITTER: Chamnan P

PROVIDER: S-EPMC3776254 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Publications

Change in HbA1c over 3 years does not improve the prediction of cardiovascular disease over and above HbA1c measured at a single time point.

Chamnan P P Simmons R K RK Khaw K T KT Wareham N J NJ Griffin S J SJ

Diabetologia 20130212 5

<h4>Aims/hypothesis</h4>HbA1c is an important risk factor for cardiovascular disease (CVD), with 1% higher HbA1c levels associated with a 10-20% increased risk of CVD. Little is known about the association between change in HbA1c over time and cardiovascular risk in non-diabetic populations. This study examined the association between change in HbA1c over time and cardiovascular risk in a non-diabetic British population.<h4>Methods</h4>We used data on HbA1c collected at baseline and at a second ...[more]

PMID: 23404444

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Dataset Information

Change in HbA1c over 3 years does not improve the prediction of cardiovascular disease over and above HbA1c measured at a single time point.

Aims/hypothesis

Methods

Results

Conclusions/interpretation

Publications

Change in HbA1c over 3 years does not improve the prediction of cardiovascular disease over and above HbA1c measured at a single time point.

Similar Datasets

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