Epidemiologic Relationships Between A1C and All-Cause Mortality During a Median 3.4-Year Follow-up of Glycemic Treatment in the ACCORD Trial

摘要: OBJECTIVE Randomized treatment comparing an intensive glycemic strategy with a standard in the Action to Control Cardiovascular Risk Diabetes (ACCORD) trial was ended early because of unexpected excess mortality arm. As part ongoing post hoc analyses potential mechanisms for this finding, we explored whether on-treatment A1C itself had independent relationship mortality. RESEARCH DESIGN AND METHODS Participants type 2 diabetes ( n = 10,251 mean age 62 years, median duration 10 and 8.1%) were randomly assigned strategies targeting either RESULTS Various characteristics participants study sites at baseline significant associations risk Before after adjustment these covariates, higher average stronger predictor than last interval follow-up or decrease first year. Higher associated greater death. The death increased approximately linearly from 6–9% appeared be only when >7%. CONCLUSIONS These implicate factors persisting levels, rather low per se, as likely contributors ACCORD.