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Abstract Aims/Introduction High glycated hemoglobin (HbA1c) variability has been reported to be linked with cardiovascular events in type 2 diabetes patients. Only a few studies have been carried out on Asian patients. This study aimed to investigate the association of prediabetes and type 2 diabetes in Asian patients by performing a post‐hoc analysis of a multicenter, prospective, observational study. Materials and methods Data for prediabetes and type 2 diabetes patients were retrieved from a multicenter national registry entitled “CORE‐Thailand study.” The primary outcome was 4P‐MACE (major adverse cardiovascular events, including non‐fatal myocardial infarction, heart failure hospitalization, non‐fatal stroke and all‐cause death). Patients were stratified according to quartiles of HbA1c standard deviation. The Cox proportional hazards regression model was used to estimate the association of HbA1c variability with incident cardiovascular disease. Results A total of 3,811 patients with prediabetes and type 2 diabetes were included. The median follow‐up duration was 54 months. In the fully adjusted model, the highest quartile of HbA1c variability showed a statistically significant association with 4P‐MACE (hazard ratio [HR] 2.77, 95% confidence interval [CI] 1.77–4.35), fatal and non‐fatal myocardial infarction (HR 6.91, 95% CI 1.90–25.12), hospitalization for heart failure (HR 3.34, 95% CI 1.20–9.26) and all‐cause death (HR 3.10, 95% CI 1.72–5.57). All these outcomes were statistically significantly different among four quartiles of HbA1c (log‐rank P‐value

Introduction: Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions in the risk factors and clinical manifestations of atherosclerotic diseases as well as management patterns.Methods: We collected data from 25 centres in Thailand. Patients with documented coronary artery disease, cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014. Data on demographics, atherosclerosis risk factors and the management pattern of risk factors, including laboratory findings, were recorded.Results: In total, 9,390 patients, including 4,861 patients with established atherosclerotic disease and 4,529 patients with multiple risk factors, were enrolled. The modifiable risk factors, other than current smoking habit (5.3%), were common: hypertension (83.8%), dyslipidaemia (85.9%) and diabetes mellitus (57.4%). A majority of patients with hypertension (96.3%), dyslipidaemia (93.8%) and diabetes mellitus (78.5%) received medications for their conditions. Antiplatelet agents were given to 73.9% of patients. The undertreatment rate of cardiovascular risk factors, such as blood pressure, low-density lipoprotein cholesterol, haemoglobin A1c and smoking status, was 35.8%, 59.0%, 45.3% and 5.3%, respectively.Conclusion: Conventional atherosclerosis risk factors were common among Thai patients with established atherosclerotic disease. Even though most of the patients received recommended treatments according to established guidelines, a significant proportion of them were undertreated for atherosclerosis risk factors. [ABSTRACT FROM AUTHOR]

Abstract Aims/Introduction Individuals with diabetes are at high risk of developing cardiovascular events. The present study investigated the predictive value of the cardio‐ankle vascular index (CAVI) when added to the Systematic Coronary Risk Evaluation 2‐Diabetes (SCORE2‐Diabetes) risk algorithm to predict cardiovascular events in the Asian population. Materials and Methods The SCORE2‐Diabetes risk was assessed in 1,502 patients with diabetes, aged 40–69 years. Then, we further stratified each 10‐year risk category with a CAVI value of 9.0. The primary outcomes (composite of all causes of death, myocardial infarction, stroke and hospitalization for heart failure) were assessed over 5 years. Results The mean age of the population was 59.8 ± 6.4 years. The proportion of 10‐year risk according to the SCORE2‐Diabetes risk of low, moderate, high and very high risk identified at 7.2, 30.0, 27.2 and 35.6%, respectively. The mean CAVI value was 8.4 ± 1.4, and approximately 35.4% of the patients had CAVI ≥9.0. The SCORE2‐Diabetes risk algorithm independently predicted the primary outcomes in patients with diabetes (hazard ratio 1.18, 95% confidence interval [CI] 1.13–1.22), whereas CAVI did not (hazard ratio 1.03, 95% CI 0.89–1.18). The C‐index for the primary outcomes of the SCORE2‐Diabetes risk algorithm alone was 0.72 (95% CI 0.67–0.77). The combination of SCORE2‐Diabetes and CAVI, both in the continuous value and risk groups, did not improve discrimination (C‐index 0.72, 95% CI 0.67–0.77 and 0.68, 95% CI 0.64–0.74, respectively). Conclusions Adding the CAVI to the SCORE2‐Diabetes risk algorithm did not improve individual risk stratification in patients with diabetes.