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OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study

INTRODUCTION: Prediabetes is defined as Hba1c 5.7% - 6.4%, with an intermediate metabolic state and includes impaired glucose tolerance and impaired fasting glucose due to insulin resistance. While Type 2 Diabetes Mellitus is a well-established risk factor for cardiovascular disease, the possible li...

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Autores principales: Jyotheeswara Pillai, Keerthana, Luo, Hongxiu, Raj, Kavin, Xu, Shuang, Thota, Geethika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624876/
http://dx.doi.org/10.1210/jendso/bvac150.510
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author Jyotheeswara Pillai, Keerthana
Luo, Hongxiu
Raj, Kavin
Xu, Shuang
Thota, Geethika
author_facet Jyotheeswara Pillai, Keerthana
Luo, Hongxiu
Raj, Kavin
Xu, Shuang
Thota, Geethika
author_sort Jyotheeswara Pillai, Keerthana
collection PubMed
description INTRODUCTION: Prediabetes is defined as Hba1c 5.7% - 6.4%, with an intermediate metabolic state and includes impaired glucose tolerance and impaired fasting glucose due to insulin resistance. While Type 2 Diabetes Mellitus is a well-established risk factor for cardiovascular disease, the possible link between Prediabetes and risk of Myocardial infarction (MI) has become a focus of interest in recent years. We wanted to evaluate if Prediabetes is independently associated with increased risk for MI. METHODS: We included adult patients admitted to teaching hospitals with a primary or secondary diagnosis of "acute myocardial infarction" from the National inpatient sample of 2016, 2017, and 2018. We created three separate multivariate logistic regression models with outcomes as MI, Percutaneous intervention (PCI), and CABG (Coronary artery bypass grafting). RESULTS: A total of 1,794,149 (95% CI 1,753,742-1,834,556) weighted hospitalizations with MI were included. Out of the 1.79 million patients with MI, 1% had Prediabetes. Prediabetes was greatly associated with increased odds for MI (OR 1.41, 95% CI 1.35-1.47, P=0.000). After adjusting for age, sex, race, family history of MI, dyslipidemia, hypertension, Diabetes, nicotine dependence, and obesity, Prediabetes was significantly associated with increased odds of MI (OR 1.25, 95% CI 1.20-1.31, P=0.000), increased odds of PCI (OR 1.45, 95% CI 1.37-1.53, P=0.000) and increased odds of CABG (OR 1.95, 95% CI 1.77-2.16, P=0.000). DISCUSSION: Our study shows that Prediabetes may be an independent risk factor for MI despite adjusting for the well-established risk factors. Coronary interventions such as PCI and CABG were highly associated with Prediabetes, suggesting macrovascular CAD. This growing evidence indicates the need to identify patients with Prediabetes and aggressively manage their cardiovascular risk factors to prevent MI. Although Prediabetes is commonly missed during coding and adds a limitation to this study, we would highlight that the association of Prediabetes with Myocardial Infarction, PCI, and CABG is a significant addition to the literature. Our study serves as a wake-up call for clinicians and patients to shift the focus to preventing Prediabetes and not just Diabetes. Our findings reinforce the importance of early recognition by screening and early intervention of Prediabetes by lifestyle changes and/or medications to decrease the risk of cardiovascular events. Presentation: Saturday, June 11, 2022 12:15 p.m. - 12:30 p.m.
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spelling pubmed-96248762022-11-14 OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study Jyotheeswara Pillai, Keerthana Luo, Hongxiu Raj, Kavin Xu, Shuang Thota, Geethika J Endocr Soc Cardiovascular Endocrinology INTRODUCTION: Prediabetes is defined as Hba1c 5.7% - 6.4%, with an intermediate metabolic state and includes impaired glucose tolerance and impaired fasting glucose due to insulin resistance. While Type 2 Diabetes Mellitus is a well-established risk factor for cardiovascular disease, the possible link between Prediabetes and risk of Myocardial infarction (MI) has become a focus of interest in recent years. We wanted to evaluate if Prediabetes is independently associated with increased risk for MI. METHODS: We included adult patients admitted to teaching hospitals with a primary or secondary diagnosis of "acute myocardial infarction" from the National inpatient sample of 2016, 2017, and 2018. We created three separate multivariate logistic regression models with outcomes as MI, Percutaneous intervention (PCI), and CABG (Coronary artery bypass grafting). RESULTS: A total of 1,794,149 (95% CI 1,753,742-1,834,556) weighted hospitalizations with MI were included. Out of the 1.79 million patients with MI, 1% had Prediabetes. Prediabetes was greatly associated with increased odds for MI (OR 1.41, 95% CI 1.35-1.47, P=0.000). After adjusting for age, sex, race, family history of MI, dyslipidemia, hypertension, Diabetes, nicotine dependence, and obesity, Prediabetes was significantly associated with increased odds of MI (OR 1.25, 95% CI 1.20-1.31, P=0.000), increased odds of PCI (OR 1.45, 95% CI 1.37-1.53, P=0.000) and increased odds of CABG (OR 1.95, 95% CI 1.77-2.16, P=0.000). DISCUSSION: Our study shows that Prediabetes may be an independent risk factor for MI despite adjusting for the well-established risk factors. Coronary interventions such as PCI and CABG were highly associated with Prediabetes, suggesting macrovascular CAD. This growing evidence indicates the need to identify patients with Prediabetes and aggressively manage their cardiovascular risk factors to prevent MI. Although Prediabetes is commonly missed during coding and adds a limitation to this study, we would highlight that the association of Prediabetes with Myocardial Infarction, PCI, and CABG is a significant addition to the literature. Our study serves as a wake-up call for clinicians and patients to shift the focus to preventing Prediabetes and not just Diabetes. Our findings reinforce the importance of early recognition by screening and early intervention of Prediabetes by lifestyle changes and/or medications to decrease the risk of cardiovascular events. Presentation: Saturday, June 11, 2022 12:15 p.m. - 12:30 p.m. Oxford University Press 2022-11-01 /pmc/articles/PMC9624876/ http://dx.doi.org/10.1210/jendso/bvac150.510 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Cardiovascular Endocrinology
Jyotheeswara Pillai, Keerthana
Luo, Hongxiu
Raj, Kavin
Xu, Shuang
Thota, Geethika
OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title_full OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title_fullStr OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title_full_unstemmed OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title_short OR02-4 Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study
title_sort or02-4 prediabetes is a risk factor for myocardial infarction-a national inpatient sample study
topic Cardiovascular Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624876/
http://dx.doi.org/10.1210/jendso/bvac150.510
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