Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups:  an analysis of 15,780 patients from the INTERHEART study

H. C. Gerstein; S. Islam; S. Anand; W. Almahmeed; A. Damasceno; A. Dans; Chim Lang; M. A. Luna; M. McQueen; S. Rangarajan; A. Rosengren; X. Wang; S. Yusuf

doi:10.1007/s00125-010-1871-0

Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study

H. C. Gerstein
, S. Islam
, S. Anand
, W. Almahmeed
, A. Damasceno
, A. Dans
, Chim Lang
, M. A. Luna
, M. McQueen
, S. Rangarajan
, A. Rosengren
, X. Wang
, S. Yusuf

Research output: Contribution to journal › Article › peer-review

53 Citations (Scopus)

Abstract

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) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (>= 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.

Original language	English
Pages (from-to)	2509-2517
Number of pages	9
Journal	Diabetologia
Volume	53
Issue number	12
DOIs	https://doi.org/10.1007/s00125-010-1871-0
Publication status	Published - 2010

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Case-control
Diabetes
Dysglycaemia
Glycated haemoglobin
Myocardial infarction
ABNORMAL GLUCOSE REGULATION
CORONARY-ARTERY-DISEASE
CARDIOVASCULAR-DISEASE
52 COUNTRIES
DIABETES-MELLITUS
HEMOGLOBIN A(1C)
HEART-FAILURE
BLOOD-GLUCOSE
MORTALITY
HOSPITALIZATION

Access to Document

10.1007/s00125-010-1871-0

Cite this

Gerstein, H. C., Islam, S., Anand, S., Almahmeed, W., Damasceno, A., Dans, A., Lang, C., Luna, M. A., McQueen, M., Rangarajan, S., Rosengren, A., Wang, X., & Yusuf, S. (2010). Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study. Diabetologia, 53(12), 2509-2517. https://doi.org/10.1007/s00125-010-1871-0

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title = "Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study",

abstract = "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) <5.4\%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (>= 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.",

keywords = "Case-control, Diabetes, Dysglycaemia, Glycated haemoglobin, Myocardial infarction, ABNORMAL GLUCOSE REGULATION, CORONARY-ARTERY-DISEASE, CARDIOVASCULAR-DISEASE, 52 COUNTRIES, DIABETES-MELLITUS, HEMOGLOBIN A(1C), HEART-FAILURE, BLOOD-GLUCOSE, MORTALITY, HOSPITALIZATION",

author = "Gerstein, \{H. C.\} and S. Islam and S. Anand and W. Almahmeed and A. Damasceno and A. Dans and Chim Lang and Luna, \{M. A.\} and M. McQueen and S. Rangarajan and A. Rosengren and X. Wang and S. Yusuf",

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doi = "10.1007/s00125-010-1871-0",

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Gerstein, HC, Islam, S, Anand, S, Almahmeed, W, Damasceno, A, Dans, A, Lang, C, Luna, MA, McQueen, M, Rangarajan, S, Rosengren, A, Wang, X & Yusuf, S 2010, 'Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study', Diabetologia, vol. 53, no. 12, pp. 2509-2517. https://doi.org/10.1007/s00125-010-1871-0

TY - JOUR

T1 - Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups

T2 - an analysis of 15,780 patients from the INTERHEART study

AU - Gerstein, H. C.

AU - Islam, S.

AU - Anand, S.

AU - Almahmeed, W.

AU - Damasceno, A.

AU - Dans, A.

AU - Lang, Chim

AU - Luna, M. A.

AU - McQueen, M.

AU - Rangarajan, S.

AU - Rosengren, A.

AU - Wang, X.

AU - Yusuf, S.

PY - 2010

Y1 - 2010

N2 - 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) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (>= 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.

AB - 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) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (>= 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.

KW - Case-control

KW - Diabetes

KW - Dysglycaemia

KW - Glycated haemoglobin

KW - Myocardial infarction

KW - ABNORMAL GLUCOSE REGULATION

KW - CORONARY-ARTERY-DISEASE

KW - CARDIOVASCULAR-DISEASE

KW - 52 COUNTRIES

KW - DIABETES-MELLITUS

KW - HEMOGLOBIN A(1C)

KW - HEART-FAILURE

KW - BLOOD-GLUCOSE

KW - MORTALITY

KW - HOSPITALIZATION

U2 - 10.1007/s00125-010-1871-0

DO - 10.1007/s00125-010-1871-0

M3 - Article

C2 - 20711717

SN - 0012-186X

VL - 53

SP - 2509

EP - 2517

JO - Diabetologia

JF - Diabetologia

IS - 12