PDB8 - HBA1C As A Risk Factor For Cardiovascular Disease in Type 2 Diabetes Mellitus: A Hospital-Based Study in Taiwan

Abstract

Cardiovascular disease (CVD) is the major cause for death in type 2 diabetes mellitus (T2DM) patients worldwide. Evidence has emerged that HbA1c may increase the risk for CVD and others. This study was to examine the relationship between HbA1c and onset cardiovascular disease, and target HbA1c in T2DM patients in Taiwan. Data in T2DM patients were extracted from Chang Gung Memorial Hospital between 2007 and 2014. CV outcome events were derived post T2DM diagnosed with data in medical charts such as HbA1c until end of the year 2014. A total of 126,079 T2DM patients were enrolled into the analysis. Per 1% unit increase in baseline HbA1c and mean HbA1c, hazard ratio (HR) for CVD were 1.05 (95% CI: 1.04 ~ 1.06, p < 0.001) and 1.31 (1.29 ~ 1.33, p < 0.001) when patients had previous CVD, respectively (p < 0.001). Per 1% unit increase in mean HbA1c, hazard of CVD increased 23% (17% ~ 29%), 21% (19% ~ 29%), and 6% (3% ~ 9%) for other treatment, oral anti-diabetic drug (OAD), and combination of insulin and OAD, respectively (all p < 0.001). Hazard of CVD increased more than 100% when mean HbA1c was higher than 8% compare with mean HbA1c was lower than 7% (p < 0.001). The rate of achieving target HbA1c level were significantly higher in OAD (1.45, 1.37 ~ 1.53) and lower in combination of insulin and OAD group (0.87, 0.82 ~ 0.93) when compared with the other treatment group (all p < 0.001). High HbA1c increases risk for CVD in T2DM patients revealed from large hospital based cohort in Taiwan. Maintenance of HbA1c control needs to be monitored continuously, especially in T2DM patients whose mean HbA1c was higher than 8%, with treatments in combination of insulin and OAD.