Long‐term glycemic exposure, glycemic control stability and incident calcific aortic valve disease: A prospective cohort study

Abstract Aims Calcific aortic valve disease (CAVD) is the most common valve disease. The impact of long‐term glycemic exposure and glycemic control on the risk of CAVD remains poorly understood, particularly in Asian populations. We examined the association of serum levels of glucose and its long‐term changes with the risk of CAVD. Materials and methods This study recruited 10 309 participants without cardiovascular disease and free of CAVD at initial echocardiographic examination from the Kailuan Study. CAVD cases were ascertained through linkage with hospitals' electronic medical record system. Data from three consecutive surveys prior to the recruitment were used to calculate the changes in glucose. Data were analysed using Cox proportional hazards regression. All participants were monitored biennially until 31 December 2023. Results A total of 2062 patients developed CAVD during a median follow‐up of 4.62 years. In multivariable Cox proportional hazards regression models, the hazard ratios for CAVD were as follows: 1.42 (95% CI, 1.29–1.57) for type 2 diabetes, 1.20 (95% CI, 1.01–1.44) for time weighted average (TWA) FBG level, 1.37 (95% CI, 1.14–1.65) for cumulative fasting blood glucose (FBG) level and 0.72 (95% CI, 0.60–0.86) for FBG time in target range (TTR). Conclusion Type 2 diabetes, long‐term elevated FBG and FBG change are associated with CAVD risk. Efforts to attain healthy glucose status may be an effective strategy to prevent CAVD.