Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study
Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study
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DOI：
10.1007/s00125-010-1871-0
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发表时间：
2010-12-01
期刊：
影响因子：
8.2
通讯作者：
Yusuf, S.
中科院分区：
文献类型：
--
作者：
Gerstein, H. C.;Islam, S.;Yusuf, S.
目的/假设虽然糖尿病是心肌梗死（MI）的既定危险因素，但疾病控制可能会有所不同。HbA（1c）是环境葡萄糖水平的可靠指标，可能提供比糖尿病状态更多的关于MI风险的信息。方法分析参与52个国家INTERHEART研究的MI患者和对照者的HbA（1c）水平之间的关系。（其中1，993人患有糖尿病），HbA（1c）的平均（SD）水平在6，761名MI患者中为6.15%（1.10），对照参与者为5.85%（0.80）。调整年龄、性别和9个主要MI风险因素（包括糖尿病）后，HbA（1c）高于最低五分之一（HbA（1c）= 6.12%）的五分之一较高者为1.55（95% CI 1.37-1.75）。在调整相同因素后作为连续变量进行分析时，HbA（1c）值每增加1%与MI几率增加19%（95% CI 14-23）相关，而HbA（1c）值每增加0.5%与MI几率增加9%（95% CI 7-11）相关。一致的关系，注意到跨亚组，与较高的OR在年轻人，患者没有糖尿病或高血压，以及那些从某些地区和ethnicity.Conclusions/解释的HbA（1c）值提供更多的信息MI的几率比自我报告的糖尿病状态或许多其他已建立的危险因素。在考虑了包括糖尿病在内的其他MI风险因素后，每增加1%独立预测MI的几率增加19%。
Aims/hypothesis Although diabetes is an established risk factor for myocardial infarction (MI), disease control may vary. HbA(1c) is a reliable index of ambient glucose levels and may provide more information on MI risk than diabetes status.Methods The relationship between HbA(1c) levels in MI patients and controls who participated in the 52 country INTERHEART study was analysed.Results In 15,780 participants with a HbA(1c) value (1,993 of whom had diabetes), the mean (SD) levels for HbA(1c) were 6.15% (1.10) in the 6,761 MI patients and 5.85% (0.80) in the control participants. After adjustment for age, sex and nine major MI risk factors (including diabetes), higher HbA(1c) fifths above the lowest fifth (HbA(1c) = 6.12%) being 1.55 (95% CI 1.37-1.75). When analysed as a continuous variable after adjustment for the same factors, every 1% higher HbA(1c) value was associated with 19% (95% CI 14-23) higher odds of MI, while every 0.5% higher HbA(1c) was associated with 9% higher odds of MI (95% CI 7-11). Concordant relationships were noted across subgroups, with a higher OR noted in younger people, patients without diabetes or hypertension, and those from some regions and ethnicities.Conclusions/interpretation The HbA(1c) value provides more information on MI odds than self-reported diabetes status or many other established risk factors. Every 1% increment independently predicts a 19% higher odds of MI after accounting for other MI risk factors including diabetes.