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Contrasting associations of body mass index and hemoglobin A1c on the excess risk of acute myocardial infarction and heart failure in type 2 diabetes mellitus

Journal of the American Heart Association Dec 18, 2019

Edqvist J, Rawshani A, Adiels M, et al. - Researchers assessed the relative as well as absolute risks for acute myocardial infarction and heart failure in type 2 diabetes mellitus by BMI and glycemic level combined vs age- and gender-matched general population comparators. Using the Swedish National Diabetes Registry, they selected 181,045 patients and 1538,434 general population comparators without diabetes mellitus, matched for age, gender, and county, all without previous major cardiovascular disease. They found substantially higher excess risk (above that of comparators in whom no data on hemoglobin A1c and BMI was available), incidence rates and hazard ratios for heart failure in obese patients vs those with low BMI, where a 7-fold risk of heart failure was observed in very obese patients (BMI ≥ 40 kg/m2) who also had poor glycemic control than comparators (reference level). In this study, BMI was identified as a strong independent risk factor for heart failure but not for acute myocardial infarction in patients suffering from type 2 diabetes mellitus.
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