dc.contributor.author | Sinning, Christoph | |
dc.contributor.author | Makarova, Nataliya | |
dc.contributor.author | Völzke, Henry | |
dc.contributor.author | Schnabel, Renate B. | |
dc.contributor.author | Ojeda, Francisco | |
dc.contributor.author | Dörr, Marcus | |
dc.contributor.author | Felix, Stephan B. | |
dc.contributor.author | Koenig, Wolfgang | |
dc.contributor.author | Peters, Annette | |
dc.contributor.author | Rathmann, Wolfgang | |
dc.contributor.author | Schöttker, Ben | |
dc.contributor.author | Brenner, Hermann | |
dc.contributor.author | Veronesi, Giovanni | |
dc.contributor.author | Cesana, Giancarlo | |
dc.contributor.author | Brambilla, Paolo | |
dc.contributor.author | Palosaari, Tarja | |
dc.contributor.author | Kuulasmaa, Kari | |
dc.contributor.author | Njølstad, Inger | |
dc.contributor.author | Mathiesen, Ellisiv B. | |
dc.contributor.author | Wilsgaard, Tom | |
dc.contributor.author | Blankenberg, Stefan | |
dc.contributor.author | Söderberg, Stefan | |
dc.contributor.author | Ferrario, Marco M. | |
dc.contributor.author | Thorand, Barbara | |
dc.date.accessioned | 2021-12-22T13:11:49Z | |
dc.date.available | 2021-12-22T13:11:49Z | |
dc.date.issued | 2021-11-15 | |
dc.description.abstract | Background: Biomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) is used to monitor the quality of diabetes treatment. Its strength of association with cardiovascular outcomes in the general population remains uncertain. This study aims to assess the association of HbA<sub>1c</sub> with cardiovascular outcomes in the general population.<p> <p>Methods: Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA<sub>1c</sub> was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular disease (CVD) incidence, and overall mortality in subjects without diabetes (N=32,496) and with diabetes (N=3684).<p> <p>Results: Kaplan–Meier curves showed higher event rates with increasing HbA<sub>1c</sub> levels (log-rank-test: p<0.001). Cox regression analysis revealed signifcant associations between HbA<sub>1c</sub> (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confdence interval (CI) 1.02–1.31, p=0.02) for cardiovascular mortality, 1.13 (95% CI 1.03–1.24, p=0.01) for CVD incidence, and 1.09 (95% CI 1.02–1.17, p=0.01) for overall mortality was observed per 10 mmol/mol increase in HbA<sub>1c</sub>. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA<sub>1c</sub> levels (HR 1.12; 95% CI 1.01–1.25, p=0.04) and HR 1.10; 95% CI 1.01–1.20, p=0.02) respectively. HbA<sub>1c</sub> cut-of values of 39.9 mmol/mol (5.8%), 36.6 mmol/mol (5.5%), and 38.8 mmol/mol (5.7%) for cardiovascular mortality, CVD incidence, and overall mortality, showed also an increased risk.<p> <p>Conclusions: HbA<sub>1c</sub> is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA<sub>1c</sub> levels and outcomes. Elevated HbA<sub>1c</sub> levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA<sub>1c</sub> levels in the overall population. | en_US |
dc.identifier.citation | Sinning, Makarova, Völzke, Schnabel, Ojeda, Dörr, Felix, Koenig, Peters, Rathmann, Schöttker, Brenner, Veronesi, Cesana, Brambilla, Palosaari, Kuulasmaa, Njølstad, Mathiesen, Wilsgaard, Blankenberg, Söderberg, Ferrario, Thorand. Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium. Cardiovascular Diabetology. 2021;20:223:1-13 | en_US |
dc.identifier.cristinID | FRIDAID 1962331 | |
dc.identifier.doi | 10.1186/s12933-021-01413-4 | |
dc.identifier.issn | 1475-2840 | |
dc.identifier.uri | https://hdl.handle.net/10037/23486 | |
dc.language.iso | eng | en_US |
dc.publisher | BMC | en_US |
dc.relation.journal | Cardiovascular Diabetology | |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP5/QLG2-CT-2002-01254/Finland/Genome-wide analyses of european twin and population cohorts to identify genes in common diseases/GENOMEUTWIN/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7/278913/Germany/Biomarker for Cardiovascular Risk Assessment in Europe/BIOMARCARE/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7/242244/Greece/Consortium on Health and Ageing: Network of Cohorts in Europe and the United States/CHANCES/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/H2020-EU.3.1.5./825903/Spain/An EU-Canada joint infrastructure for next-generation multi-Study Heart research/euCanSHare/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/H2020-EU.3.1.2./847770/Germany/DIGITAL, RISK-BASED SCREENING FOR ATRIAL FIBRILLATION IN THE EUROPEAN COMMUNITY/AFFECT-EU/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/?/BMH4-CT98-3183/?/?/?/ | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7/201413/Finland/European Network for Genetic and Genomic Epidemiology/ENGAGE/ | en_US |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2021 The Author(s) | en_US |
dc.subject | VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 | en_US |
dc.subject | VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801 | en_US |
dc.title | Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium | en_US |
dc.type.version | publishedVersion | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |