Sweet and Salty: Hemoglobin A_1c and Cardiovascular Events in Heart Failure

A progressive association exists between increasing levels of hemoglobin A_1c (HbA_1c) and cardiovascular events in individuals with or without diabetes. The toxic effects of hyperglycemia may be especially harmful to an already struggling left ventricle, placing patients with heart failure at heightened risk for adverse events.

In a prespecified analysis of 2412 participants in the manufacturer-sponsored Candesartan in Heart failure: Assessment of Reduction in Mortality and Morbidity (CHARM) study, elevated HbA_1c level was significantly associated with — and was an independent risk factor for — cardiovascular events or death. This association persisted even after adjustment for known diabetes, medication use, smoking, renal function, and othe…