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000177499 1001_ $$00000-0002-7331-8840$$aSinning, Christoph$$b0
000177499 245__ $$aAssociation of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium.
000177499 260__ $$aLondon$$bBioMed Central$$c2021
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000177499 520__ $$aBiomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A1c (HbA1c) 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 HbA1c with cardiovascular outcomes in the general population.Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA1c 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).Kaplan-Meier curves showed higher event rates with increasing HbA1c levels (log-rank-test: p < 0.001). Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confidence 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 HbA1c. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA1c 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. HbA1c cut-off 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.HbA1c is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA1c levels and outcomes. Elevated HbA1c levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA1c levels in the overall population.
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000177499 650_7 $$2Other$$aBiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe)
000177499 650_7 $$2Other$$aBiomarkers
000177499 650_7 $$2Other$$aCardiovascular risk
000177499 650_7 $$2Other$$aGlycated hemoglobin A1c (HbA1c)
000177499 650_7 $$2Other$$aMORGAM (MONICA Risk Genetics Archiving and Monograph)
000177499 650_7 $$2Other$$aMortality
000177499 7001_ $$aMakarova, Nataliya$$b1
000177499 7001_ $$aVölzke, Henry$$b2
000177499 7001_ $$aSchnabel, Renate B$$b3
000177499 7001_ $$aOjeda, Francisco$$b4
000177499 7001_ $$aDörr, Marcus$$b5
000177499 7001_ $$aFelix, Stephan B$$b6
000177499 7001_ $$aKoenig, Wolfgang$$b7
000177499 7001_ $$aPeters, Annette$$b8
000177499 7001_ $$aRathmann, Wolfgang$$b9
000177499 7001_ $$0P:(DE-He78)c67a12496b8aac150c0eef888d808d46$$aSchöttker, Ben$$b10$$udkfz
000177499 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Hermann$$b11$$udkfz
000177499 7001_ $$aVeronesi, Giovanni$$b12
000177499 7001_ $$aCesana, Giancarlo$$b13
000177499 7001_ $$aBrambilla, Paolo$$b14
000177499 7001_ $$aPalosaari, Tarja$$b15
000177499 7001_ $$aKuulasmaa, Kari$$b16
000177499 7001_ $$aNjølstad, Inger$$b17
000177499 7001_ $$aMathiesen, Ellisiv Bøgeberg$$b18
000177499 7001_ $$aWilsgaard, Tom$$b19
000177499 7001_ $$aBlankenberg, Stefan$$b20
000177499 7001_ $$aSöderberg, Stefan$$b21
000177499 7001_ $$aFerrario, Marco M$$b22
000177499 7001_ $$00000-0002-8416-6440$$aThorand, Barbara$$b23
000177499 773__ $$0PERI:(DE-600)2093769-6$$a10.1186/s12933-021-01413-4$$gVol. 20, no. 1, p. 223$$n1$$p223$$tCardiovascular diabetology$$v20$$x1475-2840$$y2021
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