Hyperglycemia, assessed according to HbA1c, and future risk of venous thromboembolism: the Tromsø study. (March 2014)

• Record Type: Journal Article
• Authors: Lerstad, G.; Brodin, E. E.; Enga, K. F.; Jorde, R.; Schirmer, H.; Njølstad, I.; Svartberg, J.; Brækkan, S. K.; Hansen, J.‐B.
• Is Part Of: Journal of thrombosis and haemostasis. Volume 12:Number 3(2014:Mar.)
• Page Start: 313
• Page End: 319
• Publication Date: 2014-03
• Subjects: Thrombosis -- Periodicals; Hemostasis -- Periodicals; Blood coagulation disorders -- Periodicals; 616.1
• DOI: 10.1111/jth.12498
• Languages: English
• ISSNs: 1538-7933

Abstract

<abstract abstract-type="main" id="jth12498-abs-0001"> <title>Summary</title> <sec id="jth12498-sec-0001" sec-type="section"> <title>Background</title> <p>HbA<sub>1c</sub>, a marker of average plasma glucose level during the previous 8–12 weeks, is associated with the future risk of cardiovascular disease and all‐cause mortality.</p> </sec> <sec id="jth12498-sec-0002" sec-type="section"> <title>Objectives</title> <p>To examine the association between hyperglycemia, assessed according to HbA<sub>1c</sub>, and the future risk of venous thromboembolism (VTE) in a population‐based cohort.</p> </sec> <sec id="jth12498-sec-0003" sec-type="section"> <title>Methods</title> <p>HbA<sub>1c</sub> was measured in 16 156 unique subjects (25–87 years) who participated in one or more surveys of the Tromsø study (Tromsø 4, 1994–1995; Tromsø 5, 2001–2002; and Tromsø 6, 2007–2008). All subjects were followed, and incident VTE events were recorded up to 31 December 2010.</p> </sec> <sec id="jth12498-sec-0004" sec-type="section"> <title>Results</title> <p>There were 333 validated first VTE events, of which 137 were unprovoked, during a median follow‐up of 7.1 years. HbA<sub>1c</sub> was not associated with the future risk of VTE in analyses treating HbA<sub>1c</sub> as a continuous variable, or in categorized analyses. The risk of VTE increased by 5% per one standard deviation (0.7%) increase in HbA<sub>1c</sub> (multivariable‐adjusted hazard ratio [HR] 1.05; 95% confidence interval [CI] 0.97–1.14), and subjects with HbA<sub>1c</sub> ≥ 6.5% had a 27% higher risk than those with HbA<sub>1c</sub> < 5.7% (multivariable‐adjusted HR 1.27; 95% CI 0.72–2.26). There was no significant linear trend for an increased risk of VTE across categories of HbA<sub>1c</sub> (<italic>P</italic> = 0.27).</p> </sec> <sec id="jth12498-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Serum levels of HbA1c were not associated with the future risk of VTE in multivariable analysis. Our findings suggest that hyperglycemia does not play an important role in the pathogenesis of VTE.</p> </sec> </abstract>