Abstract 230: Prediabetes In Young Adults And Its Association With Type 1 Myocardial Infarction-related Admissions And Outcomes: A Population-based Analysis In The United States

Abstract

Background: Prediabetes (pDM) has recently drawn attention for being associated with poor outcomes after acute myocardial infarction (MI). We aimed to analyze the incidence and odds of type 1 MI admissions, and outcomes using a nationally representative sample. Methods: We queried the National Inpatient Sample (2018) to identify T1MI-related hospitalizations (T1RH) in young (18-44 years) adults with vs without pDM using ICD-10 codes. T1RHs with DM were excluded. Demographics, comorbidities and outcomes including major cardiovascular and cerebrovascular adverse events (MACCE) were compared between two cohorts. Results: Overall prevalence of pDM in young adults hospitalized in 2018 was 0.4% (31460/7851019). T1RH was found to be significantly higher in the pDM vs. non-pDM cohort (2.15%, 675/31460 vs. 0.3%, 21655/7820953) among all non-diabetic admissions in young adults. T1RH with pDM often had males (78.5 vs 72.8%), blacks (26.7 vs 21%), Hispanics (18.3 vs 11.5%), Asian/Pacific Islanders (6.9 vs 3.1%), patients from higher-income quartile (19.1 vs 15.8%), urban-teaching (81.5 vs 72.2%), Midwest (23.7 vs 21.9%) and West (23 vs 16.4%) region hospitals, and patients with higher rates of hyperlipidemia (68.1 vs 47.3%), obesity (48.9 vs 25.7%), fluid-electrolyte imbalance (18.5 vs 15.3%). The univariate (OR 7.9, 95CI 6.54-9.53) and adjusted multivariate analysis (OR 1.71, 95CI 1.38-2.12) revealed significantly higher odds of T1MI in the pDM vs non-pDM cohort (p<0.001) [Table 1] . However, T1RH’s outcome for MACCE (adjusted) did not differ between two cohorts (P=0.074). Furthermore, T1RH with pDM had higher transfers to short-term facilities (6.7 vs 5.3%, p<0.001). Conclusion: Young patients with prediabetes had significantly higher T1MI hospitalizations without any impact on subsequent MACCEs. This highlights the need for aggressive management of CVD risk factors in the young by primary care physicians to curtail acute cardiac events and healthcare costs.

Association of Prediabetes and Recurrent Stroke in Atrial Fibrillation Patients: A Population-Based Analysis of Hospitalizations and Outcomes

“…Prior studies have linked prediabetes with myocardial infarction [2], stroke [8], electrocardiogram changes [9], heart failure [10], coronary heart disease, cancer, and dementia [5]. Recently, it has even been implicated as a risk factor for new-onset atrial fibrillation [11].…”

“…Notably, prediabetes, a condition where blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes [1], has garnered attention for its potential role as an independent risk factor in non-diabetic AF patients. While previous studies have linked prediabetes to various cardiovascular events [2], the specific association between prediabetes and recurrent stroke in individuals with AF remains a subject of investigation. By scrutinizing a large national database, we seek to contribute valuable insights that extend beyond the established realms of AF management, ultimately guiding future strategies for risk assessment, intervention, and comprehensive patient care.…”

“…Recently, prediabetes has even been found to increase the risk of myocardial infarction. Hence, we aimed to study the impact of prediabetes on atrial fibrillation [2,6]. Specifically, we conducted this population-based study that will examine the role of prediabetes in particular and co-morbidities such as age, hypertension, diabetes, prior stroke or transient ischemic attack (TIA), heart failure, and coronary artery disease in AF-related stroke patients.…”