Trial reportCardiovascular diabetology2011
Relationship between hemoglobin A1c and cardiovascular disease in mild-to-moderate hypercholesterolemic Japanese individuals: subanalysis of a large-scale randomized controlled trial.
Trial report in Cardiovascular diabetology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Prognostic significance of hemoglobin A1c level in patients hospitalized with coronary artery disease. A systematic review and meta-analysis.Cardiovascular diabetology · 2011Pooled it
- BMI-residualized data uncovers a cluster of people with type 2 diabetes and increased serum ferritin protected from cardiovascular disease.Cardiovascular diabetology · 2025Article
- Frequency and determinants of lipid management target achievement in primary prevention of cardiovascular disease in type 2 diabetes.Diabetology international · 2024Article
- Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022.Journal of atherosclerosis and thrombosis · 2024Article
- Associations Among Depression, Hemoglobin A1c Level, and Prognosis in Patients With Coronary Artery Disease: A Prospective Study.Frontiers in psychiatry · 2022Article
- Determinants of Glycated Hemoglobin in Subjects With Impaired Glucose Tolerance: Subanalysis of the Japan Diabetes Prevention Program.Journal of clinical medicine research · 2017Article
- Article
- The relationship between glycated hemoglobin and complexity of coronary artery lesions among older patients with diabetes mellitus.PloS one · 2014Article
- Better risk assessment with glycated hemoglobin instead of cholesterol in CVD risk prediction charts.European journal of epidemiology · 2013Article
- Blood glucose may be an alternative to cholesterol in CVD risk prediction charts.Cardiovascular diabetology · 2013Article
- Both cardiovascular and non-cardiovascular comorbidity are related to health status in well-controlled type 2 diabetes patients: a cross-sectional analysis.Cardiovascular diabetology · 2012Article
- Increased blood glycohemoglobin A1c levels lead to overestimation of arterial oxygen saturation by pulse oximetry in patients with type 2 diabetes.Cardiovascular diabetology · 2012Article
- Postprandial hyperglycemia and endothelial function in type 2 diabetes: focus on mitiglinide.Cardiovascular diabetology · 2012Review
- Shadow of diabetes over cardiovascular disease: comparative quantification of population-attributable all-cause and cardiovascular mortality.Cardiovascular diabetology · 2012Article
- Glycated hemoglobin and associated risk factors in older adults.Cardiovascular diabetology · 2012Article
- Mean platelet volume is associated with myocardial perfusion defect in diabetic patients.Cardiovascular journal of AfricaArticle
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough the ADA/EASD/IDF International Expert Committee recommends using hemoglobin A1c (HbA1c) to define diabetes, the relation between HbA1c and cardiovascular disease (CVD) has not been thoroughly investigated. We analyzed this relation using clinical data on Japanese individuals with hypercholesterolemia.
methodsIn the large-scale MEGA Study 7832 patients aged 40 to 70 years old with mild-to-moderate hypercholesterolemia without CVD were randomized to diet alone or diet plus pravastatin and followed for >5 years. In the present subanalysis of that study a total of 4002 patients with baseline and follow-up HbA1c data were stratified according to having an average HbA1c during the first year of follow-up <6.0%, 6.0%-<6.5%, or ≥ 6.5% and their subsequent 5-year incidence rates of CVD compared according to sex, low-density lipoprotein cholesterol (LDL-C), and treatment arm.
resultsOverall, risk of CVD was significantly 2.4 times higher in individuals with HbA1c ≥ 6.5% versus <6.0%. A similar relation was noted in men and women (hazard ratio [HR], 2.1; p <0.01 and HR, 3.0; p <0.01, respectively) and was regardless of treatment arm (diet alone group: HR, 2.2; p <0.001; diet plus pravastatin group: HR, 1.8; p = 0.02). Spline curves showed a continuous risk increase according to HbA1c level in all subpopulations studied.
conclusionsIn hypercholesterolemic individuals the risk of CVD increases linearly with HbA1c level. This significant contribution by elevated HbA1c to increased CVD is independent of pravastatin therapy, and thus requires appropriate HbA1c management in addition to lipids reduction.
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