ArticleBMC endocrine disorders2023
Impact of glycemic control on the progression of aortic stenosis: a single-center cohort study using a common data model.
Article in BMC endocrine disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 4 citations in OpenAlex.
- Shared pathophysiological mechanisms between diabetes and calcific aortic valve disease: an immunometabolic perspective.Cardiovascular diabetology · 2026Review
- Three-year risk prediction of aortic stenosis using routine medical records: derivation and validation in 919 954 individuals from two cohorts.European heart journal. Digital health · 2026Article
- Clinical characteristics and outcomes of lean diabetes mellitus in patients with moderate and severe aortic stenosis.Frontiers in cardiovascular medicine · 2026Article
- Impact of glycemic control metrics on short- and long-term mortality in transcatheter aortic valve replacement patients: a retrospective cohort study from the MIMIC-IV database.Cardiovascular diabetology · 2025Article
- Type 2 Diabetes, Circulating Metabolites, and Calcific Aortic Valve Stenosis: A Mendelian Randomization Study.Metabolites · 2024Article
- Developing RxNorm Extension: A Step Toward Global Drug Data Harmonization in Observational Drug Research.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
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7 authors at 3 institutions in 2 countries.
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Abstract
backgroundDiabetes mellitus (DM) is a well-established risk factor for the progression of degenerative aortic stenosis (AS). However, no study has investigated the impact of glycemic control on the rate of AS progression. We aimed to assess the association between the degree of glycemic control and the AS progression, using an electronic health record-based common data model (CDM).
methodsWe identified patients with mild AS (aortic valve [AV] maximal velocity [Vpeak] 2.0-3.0 m/sec) or moderate AS (Vpeak 3.0-4.0 m/sec) at baseline, and follow-up echocardiography performed at an interval of ≥ 6 months, using the CDM of a tertiary hospital database. Patients were divided into 3 groups: no DM (n = 1,027), well-controlled DM (mean glycated hemoglobin [HbA1c] < 7.0% during the study period; n = 193), and poorly controlled DM (mean HbA1c ≥ 7.0% during the study period; n = 144). The primary outcome was the AS progression rate, calculated as the annualized change in the Vpeak (△Vpeak/year).
resultsAmong the total study population (n = 1,364), the median age was 74 (IQR 65-80) years, 47% were male, the median HbA1c was 6.1% (IQR 5.6-6.9), and the median Vpeak was 2.5 m/sec (IQR 2.2-2.9). During follow-up (median 18.4 months), 16.1% of the 1,031 patients with mild AS at baseline progressed to moderate AS, and 1.8% progressed to severe AS. Among the 333 patients with moderate AS, 36.3% progressed to severe AS. The mean HbA1c level during follow-up showed a positive relationship with the AS progression rate (β = 2.620; 95% confidence interval [CI] 0.732-4.507; p = 0.007); a 1%-unit increase in HbA1c was associated with a 27% higher risk of accelerated AS progression defined as △Vpeak/year values > 0.2 m/sec/year (adjusted OR = 1.267 per 1%-unit increase in HbA1c; 95% CI 1.106-1.453; p < 0.001), and HbA1c ≥ 7.0% was significantly associated with an accelerated AS progression (adjusted odds ratio = 1.524; 95% CI 1.010-2.285; p = 0.043). This association between the degree of glycemic control and AS progression rate was observed regardless of the baseline AS severity.
conclusionIn patients with mild to moderate AS, the presence of DM, as well as the degree of glycemic control, is significantly associated with accelerated AS progression.
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