Takeaway
- The incidence of myocardial infarction (MI) was higher in men than women, but the presence of diabetes was associated with a greater excess relative risk of myocardial infarction (MI) in women than men.
- Each 1% higher glycated haemoglobin (HbA1c), independent of diabetes status, was associated with a higher risk of MI in both women and men.
Why this matters
- Previous studies on sex differences in the association between HbA1c levels and the risk of coronary heart disease (CHD) are limited and have been inconclusive.
- There is no clarity whether sex differences in the risk of CHD exist across the glycaemic spectrum.
Study design
- 471,399 individuals (56% women) without cardiovascular disease (CVD) recruited in the UK Biobank were included.
- Funding: None disclosed.
Key results
- 7316 MI events (30% in women) were recorded over a mean follow-up of 8.9 years.
- The incidence of MI was lower in women than men, regardless of diabetes status or HbA1c level (9.3 vs 27.6 per 10,000 person-years).
- Compared with no diabetes, the risk of MI was greater with prediabetes, undiagnosed diabetes and previously diagnosed diabetes in both sexes.
- In the full interaction model, previously diagnosed diabetes was strongly associated with an increased risk of MI in women (aHR, 2.33; 95% CI, 1.96-2.78) vs men (aHR, 1.81; 95% CI, 1.63-2.02), with a corresponding women-to-men ratio of HRs of 1.29 (95% CI, 1.05-1.58).
- Each 1% higher HbA1c level, independent of diabetes status, was linked with an increased risk of MI in both women (aHR, 1.18; 95% CI, 1.13-1.24) and men (aHR, 1.18; 95% CI, 1.13-1.23).
Limitations
- Results may have limited generalisability.
- Data on diagnosis of diabetes, CVD and the use of diabetes medications were self-reported.
This clinical summary first appeared on Univadis, part of the Medscape Professional Network.
