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Published on: June 11, 2012

Gender differences in clinical outcomes among diabetic patients hospitalized for cardiovascular disease

Laura Flink1, Heidi Mochari-Greenberger, Lori Mosca

  • 1Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA.

American Heart Journal
|May 28, 2013
PubMed

Insights

Diabetic women hospitalized for cardiovascular disease (CVD) with poor glycemic control (Hemoglobin A1c ≥7%) faced an 8.5-fold higher risk of 30-day rehospitalization. No such association was found in men, highlighting a critical gender difference in CVD outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Cardiovascular disease (CVD) risk is higher in diabetic women than men.
  • Gender differences in CVD outcomes for hospitalized diabetic patients are not well-established.
  • Investigating the impact of glycemic control on CVD outcomes by gender is crucial.

Purpose of the Study:

  • To determine if Hemoglobin A1c (HbA1c) levels are associated with 30-day and 1-year CVD rehospitalization and mortality in diabetic patients hospitalized for CVD.
  • To analyze these associations overall and stratified by gender.

Main Methods:

  • Prospective analysis of 902 diabetic patients hospitalized for CVD.
  • HbA1c levels were used to define glycemic control (≥7% considered poor).
  • Logistic regression and stratified models analyzed the association between HbA1c and clinical outcomes, including gender interactions.

Main Results:

  • Poor glycemic control (HbA1c ≥7%) was associated with increased 30-day CVD rehospitalization (OR 1.74).
  • A significant interaction between glycemic control and gender was observed for 30-day rehospitalization (P = .005).
  • Diabetic women with HbA1c ≥7% had an 8.5-fold higher risk of 30-day rehospitalization compared to those with HbA1c <7%; no association was found in men.

Conclusions:

  • Diabetic women hospitalized for CVD with poor glycemic control face a substantially higher risk of 30-day rehospitalization.
  • Glycemic control management in diabetic women hospitalized for CVD is critical for reducing rehospitalization.
  • Further research is needed on the trend of increased mortality risk with very low HbA1c (<6%).
Abstract

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