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Prediabetes as a risk factor for major adverse cardiovascular events
INTRODUCTION: Type II diabetes mellitus (DM) is a proinflammatory process and a known risk factor for major adverse cardiac events (MACE). The same inflammatory markers may be present in prediabetes (pDM); however, the relationship between pDM by HbA1c and MACE is not well studied. We sought to see...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Taylor & Francis
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592612/ https://www.ncbi.nlm.nih.gov/pubmed/34761971 http://dx.doi.org/10.1080/07853890.2021.2000633 |
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author | Mando, Ramy Waheed, Muhammad Michel, Adrian Karabon, Patrick Halalau, Alexandra |
author_facet | Mando, Ramy Waheed, Muhammad Michel, Adrian Karabon, Patrick Halalau, Alexandra |
author_sort | Mando, Ramy |
collection | PubMed |
description | INTRODUCTION: Type II diabetes mellitus (DM) is a proinflammatory process and a known risk factor for major adverse cardiac events (MACE). The same inflammatory markers may be present in prediabetes (pDM); however, the relationship between pDM by HbA1c and MACE is not well studied. We sought to see if pDM increases one’s risk for MACE. METHODS: We retrospectively studied patients at Beaumont Health, Michigan between 2006 and 2020. We divided patients into groups (G1–G5) based on haemoglobin A1c (HbA1c) trends over the study period as follows: G1: pDM patients who remained pDM; G2: pDM who progressed into DM; G3: pDM who normalized their HbA1c; G4: patients who maintained a normal HbA1c; and G5: patients with HbA1c persistently in the DM range. We compared MACE between the groups by univariate and multivariate regression analyses. RESULTS: A total of 119,271 patients were included in the study (G1: N = 13,520, G2: N = 6314, G3: N = 1585, G4: N = 15,018, G5: N = 82,834). Pairwise comparison revealed a statistically significant increase in the odds of MACE in all groups compared to those with normal HbA1c values (G4; p < .001). After adjusting for baseline characteristics, multivariate regression revealed elevated odds of MACE in patients with persistent pDM (G1; aOR = 1.087, p = .002) and diabetes (G2/G5; aOR = 1.25 and aOR = 1.18, p < .001) compared to individuals with normal HbA1c values. CONCLUSION: Prediabetes is a risk factor for MACE. Normalization of HbA1c values appears to decrease the adjusted risk for MACE and should be the goal in patients with pDM. KEY MESSAGES: Patients with prediabetes (pDM) are at increased risk for major cardiovascular events. Normalization of HbA1c in pDM patients may have a clinically significant benefit, in terms of lowering the MACE risk. Prediabetes patients who progress into diabetes mellitus may represent a particularly high-risk group. |
format | Online Article Text |
id | pubmed-8592612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-85926122021-11-16 Prediabetes as a risk factor for major adverse cardiovascular events Mando, Ramy Waheed, Muhammad Michel, Adrian Karabon, Patrick Halalau, Alexandra Ann Med Cardiology & Cardiovascular Disorders INTRODUCTION: Type II diabetes mellitus (DM) is a proinflammatory process and a known risk factor for major adverse cardiac events (MACE). The same inflammatory markers may be present in prediabetes (pDM); however, the relationship between pDM by HbA1c and MACE is not well studied. We sought to see if pDM increases one’s risk for MACE. METHODS: We retrospectively studied patients at Beaumont Health, Michigan between 2006 and 2020. We divided patients into groups (G1–G5) based on haemoglobin A1c (HbA1c) trends over the study period as follows: G1: pDM patients who remained pDM; G2: pDM who progressed into DM; G3: pDM who normalized their HbA1c; G4: patients who maintained a normal HbA1c; and G5: patients with HbA1c persistently in the DM range. We compared MACE between the groups by univariate and multivariate regression analyses. RESULTS: A total of 119,271 patients were included in the study (G1: N = 13,520, G2: N = 6314, G3: N = 1585, G4: N = 15,018, G5: N = 82,834). Pairwise comparison revealed a statistically significant increase in the odds of MACE in all groups compared to those with normal HbA1c values (G4; p < .001). After adjusting for baseline characteristics, multivariate regression revealed elevated odds of MACE in patients with persistent pDM (G1; aOR = 1.087, p = .002) and diabetes (G2/G5; aOR = 1.25 and aOR = 1.18, p < .001) compared to individuals with normal HbA1c values. CONCLUSION: Prediabetes is a risk factor for MACE. Normalization of HbA1c values appears to decrease the adjusted risk for MACE and should be the goal in patients with pDM. KEY MESSAGES: Patients with prediabetes (pDM) are at increased risk for major cardiovascular events. Normalization of HbA1c in pDM patients may have a clinically significant benefit, in terms of lowering the MACE risk. Prediabetes patients who progress into diabetes mellitus may represent a particularly high-risk group. Taylor & Francis 2021-11-11 /pmc/articles/PMC8592612/ /pubmed/34761971 http://dx.doi.org/10.1080/07853890.2021.2000633 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Cardiology & Cardiovascular Disorders Mando, Ramy Waheed, Muhammad Michel, Adrian Karabon, Patrick Halalau, Alexandra Prediabetes as a risk factor for major adverse cardiovascular events |
title | Prediabetes as a risk factor for major adverse cardiovascular events |
title_full | Prediabetes as a risk factor for major adverse cardiovascular events |
title_fullStr | Prediabetes as a risk factor for major adverse cardiovascular events |
title_full_unstemmed | Prediabetes as a risk factor for major adverse cardiovascular events |
title_short | Prediabetes as a risk factor for major adverse cardiovascular events |
title_sort | prediabetes as a risk factor for major adverse cardiovascular events |
topic | Cardiology & Cardiovascular Disorders |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592612/ https://www.ncbi.nlm.nih.gov/pubmed/34761971 http://dx.doi.org/10.1080/07853890.2021.2000633 |
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