1. HbA1c, Coronary atheroma progression and cardiovascular outcomes
- Author
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Iryna Dykun, Ozgur Bayturan, Julie Carlo, Steven E. Nissen, Samir R. Kapadia, E. Murat Tuzcu, Stephen J. Nicholls, and Rishi Puri
- Subjects
HbA1c ,NORMALISE, Norvasc for Regression of Manifest Atherosclerotic Lesions by Intravascular Sonographic Evaluation ,BMI, body mass index ,SATURN, The Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin ,PAV, percent atheroma volume ,MACE ,CVD, cardiovascular disease ,LDL-C, lipoprotein cholesterol ,AQUARIUS, Aliskiren Quantative Atherosclerosis Regression Intravascular Ultrasound Study ,IVUS, intravascular ultrasonography ,HDL-C, high-density lipoprotein cholesterol ,PVD, peripheral vascular disease ,Original Research Contribution ,Diabetes mellitus ,GLAGOV, Global Assessment of Plaque Regression With a PCSK9 Antibody as Measured by Intravascular Ultrasound ,IBIS 2, The Integrated Biomarkers and Imaging Study-2 ,Coronary atheroma progression ,Diseases of the circulatory (Cardiovascular) system ,STRADIVARIUS, Strategy to Reduce Atherosclerosis Development Involving Administration of Rimonabont – The Intravascular Ultrasound Study ,cardiovascular diseases ,PERISCOPE, Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation ,IVUS ,HbA1c, hemoglobin A1c ,General Medicine ,hsCRP, high-sensitivity-CRP ,REVERSAL, Reversal of Atherosclerosis With Aggressive Lipid Lowering ,TG, triglycerides ,RC666-701 ,MACE, major adverse cardiovascular events ,ACS, acute coronary syndrome ,ASCVD, atherosclerotic cardiovascular disease ,Public aspects of medicine ,RA1-1270 ,UKPDS, UK Prospective Diabetes Study - Abstract
Background and aims: We tested the hypothesis that on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events (MACE: death, myocardial infarction, cerebrovascular accident, coronary revascularization, or hospitalization for unstable angina) rates. Methods: We performed a post-hoc pooled analysis of data from seven prospective, randomized trials involving serial coronary intravascular ultrasonography (IVUS). The percent atheroma volume (PAV) was calculated as the proportion of the entire vessel wall occupied by atherosclerotic plaque. Using multivariable mixed modeling, we determined the association of on-treatment HbA1c with annualized change in PAV. Cox proportional hazard models were used to assess the association of HbA1c with incidence of MACE. Results: Among 3,312 patients (mean age 58.6±9years, 28.4%women) average on-treatment HbA1c was 6.2±1.1%. Overall, there was no net significant annualized change in PAV (0.12±0.19%, p = 0.52). In a fully adjusted multivariable analysis (following adjustment of age, sex, body mass index, systolic blood pressure, smoking, low- and high-density lipoprotein cholesterol, triglyceride levels, peripheral vascular disease, trial, region, and baseline PAV), higher on-treatment HbA1c levels were independently associated with annualized changes in PAV [beta-estimate (95% confidence interval): 0.13(0.08, 0.19), p
- Published
- 2021