Mathis, Alexandra; Villiger, Lukas; Reiner, Martin F; Egloff, Michael; Schmid, Hans Ruedi; Stivala, Simona; Limacher, Andreas; Méan, Marie; Aujesky, Drahomir; Rodondi, Nicolas; Angelillo, Anne; Righini, Marc; Staub, Daniel; Aschwanden, Markus; Frauchiger, Beat; Osterwalder, Joseph; Kucher, Nils; Matter, Christian M; Banyai, Martin; Hugli, Oliver; ... (2020). Elevated HbA1c is not associated with recurrent venous thromboembolism in the elderly, but with all-cause mortality- the SWEETCO 65+ study. Scientific Reports, 10(1), p. 2495. Nature Publishing Group 10.1038/s41598-020-59173-2
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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.
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