Do HbA1c Levels Help Cardiovascular Risk Assessment?

Including HbA1c levels in conventional cardiovascular risk assessment provided little benefit in nondiabetic patients, according to a new study.

In order to determine the value of glucose measurement in gauging CV risk, researchers analyzed data from 73 studies involving 294,998 patients without history of diabetes or cardiovascular events at baseline.
_____________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
When the A1c is Unreliable
Screening for Type 2 Diabetes with A1c Testing
_____________________________________________________________________________________________________________________________________________________________________

During a median follow-up of 10 years, researchers observed 13,237 instances of coronary heart disease and 7,603 strokes. A J-shaped association between glucose levels and CV risk was found, which attenuated after adjusting for HDL cholesterol and c-reactive protein.

Overall, the benefit of assessing glucose levels was minimal, confirming that in nondiabetic patients, established risk factors—including lipids, blood pressure, age, gender, and smoking status—are sufficient in determining CV risk.

“Additional assessment of HbA1c values in the context of CV risk assessment provided little incremental benefit for prediction of CV risk,” researchers concluded.

–Michael Potts

Emerging Risk Factors Collaboration. Glycated Hemoglobin Measurement and Prediction of Cardiovascular Disease. JAMA. 2014;311(12):1225-1233. doi:10.1001/jama.2014.1873.