Impact of Baseline Glycemic Control on Residual Cardiovascular Risk in Patients With Diabetes Mellitus and High-Risk Vascular Disease Treated With Statin Therapy

In the context of the ACCELERATE* trial, which included 12,092 patients with diabetes mellitus (DM) and established coronary artery disease, a subanalysis was conducted to examine the relationship between baseline HbA1c and future cardiovascular (CV) events among participants.

The trial had a primary end point of MACE (CV death, nonfatal myocardial infarction (MI), stroke, coronary revascularization, or hospitalization for unstable angina); and a secondary end point, that included the composite of the first 3 CV events (CV death, nonfatal MI, and stroke). With the objective to analyze the impact of HbA1c on those events, the study measured the HbA1c levels at the beginning of the study and grouped them from HbA1c < 6% to HbA1c ≥ 8%.

The results showed that the group with baseline HbA1c ≥ 8% had 5.6% more risk of MACE than the group with baseline HbA1c <6% (p<0.001). Likewise, that group had 3.5% more risk of suffering a composite of CV death, nonfatal MI, and stroke than the group with baseline HbA1c <6% (p=0.003).

Thus, HbA1c was found to be a strong independent predictor for major adverse cardiac events in the ACCELERATE trial. These findings will enable clinicians to increase the awareness of the HbA1c levels and choose medications that have scientifically proven to lower those levels tin order to improve cardiovascular outcomes.

• ACCELERATE: Assessment of Clinical Effects of Cholesteryl Ester Transfer Protein Inhibition with Evacetrapib in Patients at a High Risk for Vascular Outcomes

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SCAC 07/22 DM 073 DIA