Lipids & metabolic liver disease
Longitudinal blood glucose level and increased silent myocardial infarction: a pooled analysis of four cohort studies
Authors' conclusion
Higher longitudinal FG and larger intra-individual variability in FG over time were associated in a dose-response manner with a higher SMI risk. These findings support the significance of routine cardiac screening for subjects with elevated FG, with and without diabetes.
Study context
- Population
- Individuals free of MI history at baseline from four prospective cohort studies; mean age 60.5 (SD 10.3) years, median baseline fasting glucose (FG) 97.3 mg/dL
- Participants
- 24,732 individuals4 cohort studies
- Comparison
- Longitudinal FG levels
- Outcome
- Silent MI (SMI), identified by 12-lead ECG with Minnesota codes and medical history
- Follow-up
- Average 9 years
Methodological detailstime-dependent Cox regression, adjusted for age, gender, race, study, smoking, longitudinal BMI, LDL-C, blood pressure and serum creatinine
- Time-dependent Cox regression
- Adjusted for age, gender, race, study, smoking, longitudinal BMI, LDL-C, blood pressure and serum creatinine
Pooled result
As reported in the abstract
Association between FG and silent myocardial infarction (SMI) was linear; each 25 mg/dL FG increment associated with increased SMI risk
15%
HR per 25 mg/dL, further adjusted for lipid-lowering, antihypertensive, antidiabetic medication and insulin
1.08
95% CI 1.01–1.16
Further pooled results
SMI events · average 9 years
- SMI events
- 357
- Incidence rate
- 1.3 per 1000 person-years
SMI risk per 25 mg/dL increase in average FG over visits
- HR per 25 mg/dL increase
- 1.17 (95% CI 1.08-1.26)
SMI risk per 1 SD increase in FG variability over visits
- HR per 1 SD increase
- 1.23 (95% CI 1.12-1.34)
Original publication
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