title: Hemoglobin A1c predicts heart failure hospitalization independent of baseline cardiac function or B-type natriuretic peptide level.
abstract: OBJECTIVE
  Diabetes is a major risk factor for heart failure (HF). We examined whether baseline HbA1c level predicts HF incidence independent of other HF risk factors, including baseline cardiac structural and functional abnormalities.
  
  
  METHODS
  In patients with type 2 diabetes, multivariable Cox regression models were constructed to examine the independent association between baseline HbA1c and future HF hospitalization.
  
  
  RESULTS
  In 608 subjects (mean age, 66.5 years; men, 68%; mean HbA1c, 9.1% (76 mmol/mol)), 92 were hospitalized for HF during a median follow-up of 6 years. For a 1% (11 mmol/mol) increase in baseline HbA1c, the hazard ratio for HF was 1.23 (95% confidence interval, 1.1-1.7, p<0.001) with adjustment for age, sex, body mass index, blood pressure and plasma B-type natriuretic peptide (BNP) level. The effect of HbA1c on HF was independent of baseline left ventricular (LV) ejection fraction, the ratio of peak early to late diastolic filling velocity, and prevalent/incident coronary heart disease (CHD), and was more evident in patients with enlarged LV, decreased systolic function, prevalent CHD, or prevalent HF.
  
  
  CONCLUSIONS
  In patients with type 2 diabetes, HbA1c significantly predicts future HF hospitalization independent of baseline BNP level or echocardiographic parameters.
authors.affiliation: Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: kishimot@hsp.ncvc.go.jp.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kishimoto
authors.affiliation: Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Makino
authors.affiliation: Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohata
authors.affiliation: Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Tamiko
authors.initials: T
authors.lastname: Tamanaha
authors.affiliation: Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Tochiya
authors.affiliation: Department of Advanced Medical Technology Development, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kada
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D016276:Ventricular Function / Q000502:physiology*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D020097:Natriuretic Peptide, Brain
keywords: Glycated hemoglobin; Heart failure; Type 2 diabetes