Prediabetes is not an independent risk factor for incident heart failure, other cardiovascular events or mortality in older adults: Findings from a population-based cohort study

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:168

Article

Deedwania, Prakash¹  Patel, Kanan²  Fonarow, Gregg C.³  Desai, Ravi V.⁴  Zhang, Yan²  Feller, Margaret A.²  Ovalle, Fernando²  Love, Thomas E.⁵  Aban, Inmaculada B.²  Mujib, Marjan⁶  Ahmed, Mustafa I.²  Anker, Stefan D.⁷  Ahmed, Ali^2,8 

[1] Univ Calif San Francisco, San Francisco, CA 94143 USA

[2] Univ Alabama Birmingham, Birmingham, AL 35294 USA

[3] Univ Calif Los Angeles, Los Angeles, CA USA

[4] Lehigh Valley Hosp, Allentown, PA USA

[5] Case Western Reserve Univ, Cleveland, OH 44106 USA

[6] New York Med Coll, Valhalla, NY 10595 USA

[7] IRCCS San Raffaele, Ctr Clin & Basic Res, Rome, Italy

[8] Vet Affairs Med Ctr, Birmingham, AL USA

关键词: Prediabetes;    Diabetes;    Heart failure;    Older adults;    Propensity-matched study;   

DOI  :  10.1016/j.ijcard.2013.05.038

来源: Elsevier

【 摘 要 】

Background: Whether prediabetes is an independent risk factor for incident heart failure (HF) in non- diabetic older adults remains unclear. Methods: Of the 4602 Cardiovascular Health Study participants, age = 65 years, without baseline HF and diabetes, 2157 had prediabetes, defined as fasting plasma glucose (FPG) 100- 125 mg/ dL. Propensity scores for prediabetes, estimated for each of the 4602 participants, were used to assemble a cohort of 1421 pairs of individuals with and without prediabetes, balanced on 44 baseline characteristics. Results: Participants had a mean age of 73 years, 57% were women, and 13% African American. Incident HF occurred in 18% and 20% of matched participants with and without prediabetes, respectively (hazard ratio {HR} associated with prediabetes, 0.90; 95% confidence interval {CI}, 0.76- 1.07; p = 0.239). Unadjusted and multivariable- adjusted HRs (95% CIs) for incident HF associated with prediabetes among 4602 pre- match participants were 1.22 (95% CI, 1.07- 1.40; p = 0.003) and 0.98 (95% CI, 0.85- 1.14; p = 0.826), respectively. Amongmatched individuals, prediabetes had no independent associationwith incident acutemyocardial infarction (HR, 1.02; 95% CI, 0.81- 1.28; p = 0.875), angina pectoris (HR, 0.93; 95% CI, 0.77- 1.12; p = 0.451), stroke (HR, 0.86; 95% CI, 0.70- 1.06; p = 0.151) or all- cause mortality (HR, 0.99; 95% CI, 0.88- 1.11; p = 0.840). Conclusions: We found no evidence that prediabetes is an independent risk factor for incident HF, other cardiovascular events or mortality in community- dwelling older adults. These findings question the wisdom of routine screening for prediabetes in older adults and targeted interventions to prevent adverse outcomes in older adults with prediabetes. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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