Hemoglobin A1c Level vs. Diagnosis of Diabetes as a Predictor of Cardiovascular Risk

Adding glycosylated hemoglobin measurement improved ability to predict cardiovascular risk, but the clinical implications are unclear.

In the widely used Adult Treatment Panel (ATP) III guideline, diabetes is a coronary risk equivalent, conferring a 10-year risk for adverse coronary events that exceeds 20%. However, this designation clearly overstates 10-year risk for some patients. Because glycosylated hemoglobin (HbA_1c) has been proposed as a more refined predictor of risk, researchers assessed measurement of HbA_1c in two prospective cohort studies: the Women's Health Study (24,674 women; median follow-up, 10.2 years) and the Physicians' Health Study II (11,280 men; median follow-up, 11.8 years).

For diabetic women in the Women's Health Study, adding HbA_1c to the ATP III model (which includes entries for smoking, blood pressure, and lipids) improved predictive accuracy fo…

Reviewing Authors

Thomas L. Schwenk, MD

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Editorial BoardsUpToDate

Thomas L. Schwenk, MD

Disclosures

Editorial BoardsUpToDate

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Hemoglobin A_1c Level vs. Diagnosis of Diabetes as a Predictor of Cardiovascular Risk

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Reviewing Authors