Abstract

The association of glycated hemoglobin (HbA1c) with venous thromboembolism (VTE) and death in the elderly is unknown. In the SWEETCO 65+ study we analyzed prospectively a Swiss Cohort of Elderly Patients with Venous Thromboembolism (SWITCO 65+). 888 patients were enrolled for the SWEETCO 65+ analysis. HbA1c was determined at baseline and divided into three categories (HbA1c < 5.7%, normal range; 5.7–6.49%, pre-diabetic range; and >6.5%, diabetic range). Median follow-up was 2.5 years. The primary endpoint was recurrent VTE. Secondary endpoints included all-cause mortality and major bleeds. The total prevalence of diabetes was 22.1%. The risk of recurrent VTE was similar in patients with HbA1c with pre-diabetes (adjusted subhazard ratio (aSHR) 1.07 [0.70 to 1.63]) and diabetes (aSHR 0.73 [0.39 to 1.37]) as compared to those with a HbA1c in the normal range. However, a HbA1c ≥ 6.5% (median IQ range 7.0 [6.70;7.60]) was significantly associated with a higher risk of all-cause mortality (adjusted hazard ratio [aHR] 1.83 [1.21 to 2.75]). In summary we found no association between HbA1c and major bleeding. Elevated HbA1c levels are not associated with recurrent VTE but with increased all-cause mortality in an elderly population with acute VTE.

Details

Title
Elevated HbA1c is not associated with recurrent venous thromboembolism in the elderly, but with all-cause mortality– the SWEETCO 65+ study
Author
Mathis, Alexandra 1 ; Villiger Lukas 1 ; Reiner, Martin F 2 ; Egloff, Michael 3 ; Schmid, Hans Ruedi 4 ; Stivala Simona 5   VIAFID ORCID Logo  ; Limacher, Andreas 6 ; Mean Marie 7 ; Aujesky Drahomir 8 ; Rodondi Nicolas 9 ; Angelillo-Scherrer Anna 10 ; Righini, Marc 11 ; Staub, Daniel 12 ; Aschwanden, Markus 12 ; Frauchiger Beat 13 ; Osterwalder, Joseph 14 ; Kucher Nils 15 ; Matter, Christian M 16 ; Banyai, Martin 17 ; Hugli Oliver 18   VIAFID ORCID Logo  ; Beer, Juerg H 19 

1  DiaMon Institute, Baden-Dättwil, Switzerland 
2  Cantonal Hospital of Baden, Department of Internal Medicine, Baden, Switzerland; University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland (GRID:grid.7400.3) (ISNI:0000 0004 1937 0650) 
3  Cantonal Hospital of Baden, Department of Internal Medicine, Baden, Switzerland (GRID:grid.7400.3) 
4  Cantonal Hospital of Baden, Central Laboratory, Baden, Switzerland (GRID:grid.7400.3) 
5  University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland (GRID:grid.7400.3) (ISNI:0000 0004 1937 0650) 
6  University of Bern, CTU Bern, and Institute of Social and Preventive Medicine (ISPM), Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157) 
7  Bern University Hospital, Inselspital, University of Bern, Division of General Internal Medicine, Bern, Switzerland (GRID:grid.5734.5); Lausanne University Hospital, Division of Internal Medicine, Lausanne, Switzerland (GRID:grid.8515.9) (ISNI:0000 0001 0423 4662) 
8  Bern University Hospital, Inselspital, University of Bern, Division of General Internal Medicine, Bern, Switzerland (GRID:grid.8515.9) 
9  Bern University Hospital, Inselspital, University of Bern, Division of General Internal Medicine, Bern, Switzerland (GRID:grid.8515.9); University of Bern, Institute of Primary Health Care (BIHAM), Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157) 
10  Bern University Hospital, Inselspital, University of Bern, Department of Hematology and Central Hematology Laboratory, Bern, Switzerland (GRID:grid.5734.5); University of Bern, Department of Bio Medical Research, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157) 
11  Geneva University Hospital, Division of Angiology and Hemostasis, Geneva, Switzerland (GRID:grid.150338.c) (ISNI:0000 0001 0721 9812) 
12  Basel University Hospital, Division of Angiology, Basel, Switzerland (GRID:grid.410567.1) 
13  Cantonal Hospital of Frauenfeld, Department of Internal Medicine, Frauenfeld, Switzerland (GRID:grid.410567.1) 
14  Cantonal Hospital of St. Gallen, St. Gallen, Switzerland (GRID:grid.413349.8) (ISNI:0000 0001 2294 4705) 
15  Zurich University Hospital, Division of Angiology, Zurich, Switzerland (GRID:grid.412004.3) (ISNI:0000 0004 0478 9977) 
16  University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland (GRID:grid.7400.3) (ISNI:0000 0004 1937 0650); University Heart Center, Zurich University Hospital, Department for Cardiology, Zurich, Switzerland (GRID:grid.412004.3) (ISNI:0000 0004 0478 9977) 
17  Cantonal Hospital of Lucerne, Division of Angiology, Lucerne, Switzerland (GRID:grid.413354.4) (ISNI:0000 0000 8587 8621) 
18  Lausanne University Hospital, Emergency Department, Lausanne, Switzerland (GRID:grid.8515.9) (ISNI:0000 0001 0423 4662) 
19  Cantonal Hospital of Baden, Department of Internal Medicine, Baden, Switzerland (GRID:grid.8515.9); University of Zurich, Center for Molecular Cardiology, Schlieren, Switzerland (GRID:grid.7400.3) (ISNI:0000 0004 1937 0650) 
Publication year
2020
Publication date
2020
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-020-59173-2
ProQuest document ID
2354106263
Copyright
This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.