Interpreting Hemoglobin A1C in Combination With Conventional Risk Factors for Prediction of Cardiovascular Risk

Circulation. Cardiovascular Quality and Outcomes
Jamie A JarmulMark J Pletcher

Abstract

Hemoglobin A1C (HbA1C) is associated with increased risk of cardiovascular events, but its use for prediction of cardiovascular disease (CVD) events in combination with conventional risk factors has not been well defined. To understand the effect of HbA1C on CVD risk in the context of other CVD risk factors, we analyzed HbA1C and other CVD risk factor measurements in 2000 individuals aged 40 to 79 years without pre-existing diabetes mellitus or CVD from the 2011 to 2012 National Health and Nutrition Examination Surveys survey. The resulting regression model was used to predict the HbA1C distribution based on individual patient characteristics. We then calculated post-test 10-year atherosclerotic CVD risk incorporating the actual versus predicted HbA1C, according to established methods, for a set of example scenarios. Age, sex, race/ethnicity, and traditional cardiovascular risk factors were significant predictors of HbA1C in our model, with the expected HbA1C distribution being significantly higher in non-Hispanic black, non-Hispanic Asian, and Hispanic individuals than that in non-Hispanic white/other individuals. Incorporating the expected HbA1C distribution into pretest atherosclerotic CVD risk has a modest effect on post-te...Continue Reading

References

Mar 5, 2010·The New England Journal of Medicine·Elizabeth SelvinFrederick L Brancati
Feb 1, 2013·American Journal of Epidemiology·Sherri Rose
Mar 13, 2014·Circulation. Cardiovascular Quality and Outcomes·Mark J PletcherPhilip Greenland
Mar 29, 2014·JAMA : the Journal of the American Medical Association·UNKNOWN Emerging Risk Factors CollaborationJohn Danesh
Apr 16, 2014·Annals of Internal Medicine·Elizabeth SelvinJosef Coresh
Dec 4, 2014·The Lancet. Respiratory Medicine·Romain PirracchioMark J van der Laan

❮ Previous
Next ❯

Citations

Sep 10, 2015·Circulation. Cardiovascular Quality and Outcomes·Khurram Nasir

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.