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.
Cite this: Diabetes Confers Greater Excess Risk of Myocardial Infarction in Women Than Men - Medscape - Jul 16, 2020.
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