Diabetes Confers Greater Excess Risk of Myocardial Infarction in Women Than Men

Sarfaroj Khan 

July 16, 2020

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.

 

de Jong M, Woodward M, Peters SAE. Diabetes, Glycated Hemoglobin, and the Risk of Myocardial Infarction in Women and Men: A Prospective Cohort Study of the UK Biobank. Diabetes Care. 2020 Jul 10 [Epub ahead of print]. doi: 10.2337/dc19-2363. PMID: 32651263.  Abstract.

This clinical summary first appeared on Univadis, part of the Medscape Professional Network.

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