{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:43:09Z","timestamp":1791996189650,"version":"4.4.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Whether glycaemic control is associated with cardiovascular outcomes in patients with type 2 diabetes (T2D) is unclear. Consequently, we assessed the relationship between glycated haemoglobin (HbA1c) and cardiovascular outcomes in a placebo-controlled randomized trial which demonstrated no cardiovascular effect of sitagliptin in patients with T2D and atherosclerotic vascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Secondary analysis of 14\u2009656 TECOS participants with time to event analyses using multivariable Cox proportional hazard models. During a median 3.0 (interquartile range 2.3\u20133.8) year follow-up, 456 (3.1% of 14\u2009656) patients had first hospitalization for heart failure (HF), 1084 (11.5%) died, 1406 (9.6%) died or were hospitalized for HF, and 1689 (11.5%) had a non-HF cardiovascular event (cardiovascular death, non-fatal stroke, non-fatal myocardial infarction, or hospitalization for unstable angina). Associations between baseline or time-varying HbA1c and cardiovascular outcomes were U-shaped, with the lowest risk when HbA1c was around 7%. Each one-unit increase in the time-varying HbA1c above 7% was associated with an adjusted hazard ratio (HR) of 1.21 [95% confidence interval (CI) 1.11\u20131.33] for first HF hospitalization, 1.11 (1.03\u20131.21) for all-cause death, 1.18 (1.09\u20131.26) for death or HF hospitalization, and 1.10 (1.02\u20131.17) for non-HF cardiovascular events. Each one-unit decrease in the time-varying HbA1c below 7% was associated with an adjusted HR of 1.35 (95% CI 1.12\u20131.64) for first HF hospitalization, 1.37 (1.16\u20131.61) for death, 1.42 (1.23\u20131.64) for death or HF hospitalization, and 1.22 (1.06\u20131.41) for non-HF cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Glycated haemogobin exhibits a U-shaped association with cardiovascular outcomes in patients with T2D and atherosclerotic vascular disease, with nadir around 7%.<\/jats:p>\n                    <jats:p>Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT00790205.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1958","type":"journal-article","created":{"date-parts":[[2020,7,4]],"date-time":"2020-07-04T06:44:46Z","timestamp":1593845086000},"page":"2026-2034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Association Between Glycated Haemoglobin Levels and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Cardiovascular Disease: A Secondary Analysis of the TECOS Randomized Clinical Trial"],"prefix":"10.1093","volume":"22","author":[{"given":"Finlay A.","family":"McAlister","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry, University of Alberta , Edmonton ,","place":["Canada"]},{"name":"Canadian VIGOUR Centre, University of Alberta , Edmonton ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinggan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre, University of Alberta , Edmonton ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia M.","family":"Westerhout","sequence":"additional","affiliation":[{"name":"Canadian VIGOUR Centre, University of Alberta , Edmonton ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Buse","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of North Carolina School of Medicine , Chapel Hill, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberhard","family":"Standl","sequence":"additional","affiliation":[{"name":"Diabetes Research Group, Munich Helmholtz Center , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren K.","family":"McGuire","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Texas Southwestern Medical Center , Dallas, TX 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