Evidence mapPaperPMID 41137002Full record

Observational studyCardiovascular diabetology2025

Interplay of glycated hemoglobin and traditional risk factors for the risk of atherosclerotic cardiovascular disease and all-cause mortality in people without diabetes.

Soroush Masrouri, Amirhossein Hasanpour, Navid Ebrahimi, Farzad Hadaegh

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

4 authors.

Soroush MasrouriPrevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, P.O. Box: 19395-4763, Velenjak, Tehran, Iran.
Amirhossein Hasanpour *Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, P.O. Box: 19395-4763, Velenjak, Tehran, Iran.
Navid Ebrahimi *Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, P.O. Box: 19395-4763, Velenjak, Tehran, Iran.
Farzad HadaeghPrevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Yamen Street, P.O. Box: 19395-4763, Velenjak, Tehran, Iran. fzhadaegh@endocrine.ac.ir.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo assess the impact of glycated hemoglobin A1c (HbA1c) in individuals without diabetes and at the extremes of cardiovascular risk factor (CVRF) burden on the incidence of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality.

methodsWe studied 20,360 U.S. adults, initially free of diabetes and ASCVD from the CARDIA, MESA, ARIC, and FOS cohorts, all with available HbA1c data. The mean (standard deviation) age was 57.1 (9.1) years [56.2% women and 21.9% Black]. Using multivariable Cox proportional hazard regression, ASCVD and all-cause mortality were analyzed over a median 16.7-year follow-up across categories of CVRF burden (0, 1, 2, or 3 of dyslipidemia, smoking, and hypertension) and HbA1c levels (< 5.0%, 5.0-5.4% [reference], 5.5-5.9%, and 6.0-6.4%).

resultsDuring follow-up, 3592 ASCVD events (17.6%) and 6627 deaths (32.6%) occurred. The hazard ratios (HRs) and 95% confidence intervals (CIs) for HbA1c levels of 5.5-5.9% and 6.0-6.4% for ASCVD were 1.17 (1.09-1.26) and 1.59 (1.42-1.78), respectively. The corresponding HRs for mortality were 1.14 (1.07-1.20) and 1.35 (1.24-1.47). HbA1c < 5.0% was also associated with an elevated mortality risk (HR, 95% CI 1.17, 1.07-1.28). Among individuals with 0 CVRFs, the HRs for ASCVD risks ranged from 1.26 (1.02-1.55) for HbA1c 5.5-5.9% to 1.68 (1.12-2.54) for HbA1c 6.0-6.4%. For those with 3 CVRFs, the corresponding HRs were 1.22 (0.88-1.69) and 2.00 (1.35-2.97). Similar findings were observed for all-cause mortality. Subgroup analysis revealed that HbA1c ≥ 5.5% was associated with an increased mortality risk in non-Black individuals but did not reach statistical significance in Black individuals (P interaction < 0.001).

conclusionsHbA1c testing in individuals without diabetes may help identify those at higher risk for ASCVD and mortality, even at the extremes of CVRF burden.

Indexed as

AtherosclerosisGlycated HemoglobinAgedBiomarkersCause of DeathDyslipidemiasFemaleHeart Disease Risk FactorsHumansIncidenceMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentRisk FactorsBiomarkersGlycated Hemoglobinhemoglobin A1c protein, human

Identifiers

PMID41137002
PMCPMC12553162

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.