Higher A1c levels tied to aortic stenosis progression: Study
South Korea: Higher A1c levels in patients with mild or moderate aortic stenosis (AS) are significantly associated with a faster rate of AS progression, a recent study has revealed. The study, published in Research Square as a preprint, imply that more intensive glycemic control might be beneficial for preventing AS progression in patients with diabetes mellitus (DM) and mild to moderate AS.
Diabetes presence is considered a well-estabkished risk factor for degenerative AS progression. However, no study has examined the impact of blood sugar control on AS progression rate. Considering this, In-Chang Hwang, Seoul National University Bundang Hospital, South Korea, and colleagues aimed to assess the association between degree of glycemic control and AS progression using an electronic health record-based common data model (CDM).
For the purpose, the researchers identified 1420 patients with mild to moderate AS (defined as an aortic valve [AV] maximal velocity [Vpeak] of 2.0–4.0 m/sec) at baseline, and follow-up echocardiography performed at an interval of ≥6 months. The participants were divided into three groups: no DM (n=1037), well-controlled DM (mean glycated hemoglobin [HbA1c] <7.0% during the study period; n=186), and poorly controlled DM (mean HbA1c ≥7.0% during the study period; n=143).
AS progression rate, calculated as the annualized change in the Vpeak (△Vpeak/year) was the primary outcome.
Salient findings include:
- During follow-up (median 18.4 months), the total study population showed a gradual progression in AS severity.
- The mean HbA1c level during follow-up was proportionally associated with a higher AS progression rate (β=0.024); a 1% increase in HbA1c was associated with a 27% higher risk of accelerated AS progression, and HbA1c ≥7.0% was significantly associated with an accelerated AS progression (adjusted odds ratio=1.524).
- This association between the degree of glycemic control and AS progression rate was observed regardless of the baseline AS severity.
"The degree of glycemic control in patients with mild to moderate AS was significantly associated with AS progression," wrote the authors. "More intensive glycemic control might be beneficial for preventing AS progression in patients with DM and mild to moderate AS."
Reference:
The preprint research study titled "Impact of Glycemic Control on the Progression of Aortic Stenosis: a Common Data Model Cohort Study," appears in Research Square and will be published in the journal BMC Endocrine Disorders post-review.
DOI: 10.21203/rs.3.rs-1173479/v1
KEYWORDS: aortic stenosis, progression, A1c, blood sugar, glycemic control, diabetes mellitus, diabetes, Research Square, In-Chang Hwang, diabetes, HbA1c, glycated hemoglobin, AS progression
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