Relationship Between Rising A1C and Stroke Risk

May 17, 2018. A systematic review and meta-analysis of 29 observational cohort and nested case-control studies comprising 532,779 participants was conducted to assess the association between rising A1C levels and stroke risk. Participants were aged ≥18 years and had type 1 or type 2 diabetes or did not have diabetes. A1C ≥6.5% was associated with an increased risk of first-ever stroke (average hazard ratio [HR]: 2.15, 95% confidence interval [CI]: 1.76, 2.63) compared to A1C <5.7%. Results were not significant for A1C 5.7% to 6.5% (average HR: 1.19, 95% CI: 0.87, 1.62). In participants with A1C <5.7%, average HR (95% CI) for first-ever stroke was 1.12 (0.91, 1.39) for every 1% A1C increment and 1.17 (1.09, 1.25) in participants with A1C ≥6.5%. For every 1% A1C increment, both the A1C <5.7% and A1C ≥6.5% cohorts had a higher associated risk of first‐ever ischemic stroke (average HR: 1.49, 95% CI: 1.32, 1.69 and HR: 1.24, 95% CI: 1.11, 1.39, respectively). The authors concluded that intensive A1C targets may help prevent ischemic stroke. Read the abstract here.