DOC News December 1, 2005
Volume 2 Number 12 p. 12
© 2005 American Diabetes Association
A1C Is Coronary Disease Predictor
Chronic hyperglycemia has long been a suspected culprit in the development
of coronary heart disease (CHD). As a marker of long-term glycemic control,
glycated hemoglobin (A1C) is a useful and reliable risk indicator for
developing CHD, even in people without diabetes whose A1C levels are in the
high normal range, according to a study published in the September 12 issue of
Archives of Internal Medicine.
The researchers conducted a prospective study of 1,321 adults without
diabetes and a cohort of 1,626 adults with diabetes in the Atherosclerosis
Risk in Communities Study. CHD and other outcomes were tallied for an 8- to
10-year follow-up period.
Overall, researchers found that those with diabetes who had the highest A1C
levels were more than twice as likely to develop CHD than those with the
lowest A1C levels.
Among subjects without diabetes, those with the highest levels of A1C were
about 1.5 times more likely to develop CHD than nondiabetic patients with the
lowest levels. No greater risk of CHD was noted at A1C levels 
4.6% in this
group, while risk of CHD increased significantly when A1C levels were
4.6%. Each 1% increase in A1C over 4.6% raised the risk of CHD nearly 2.5
times, according to researchers.
Selvin E, Coresh J, Golden SH, et al.: Glycemic control and
coronary heart disease risk in persons with and without diabetes: The
Atherosclerosis Risk in Communities Study. Arch Intern
Med 16:1910–1916, 2005.
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