Prediabetes and all-cause mortality in young patients undergoing coronary artery angiography: a multicenter cohort study in China

Abstract

Background The prevalence of prediabetes is increasing in young adults and patients undergoing coronary angiography. However, whether prediabetes is a considerable risk factor for all-cause mortality remains undetermined in young patients undergoing coronary angiography. Methods In this study, we retrospectively included 8868 young patients (men aged < 45 years, women aged < 55 years) who underwent coronary angiography (CAG). Patients were categorized as normoglycemic, prediabetes and diabetes according to the HbA1c level or documented history of diabetes. The association of all-cause mortality with diabetes and prediabetes was detected by Cox proportional hazards regression analysis. Results A total of 3240 (36.5%) among 8868 young patients receiving CAG were prediabetes and 2218 (25.0%) were diabetes. 728 patients died during a median follow-up of 4.92 years. Compared to the normoglycemic group, prediabetes increased the risk of all-cause mortality in young CAG patients by 24%(adjusted HR: 1.24, 95% CI: 1.04–1.49, p = 0.019) and diabetes increased the risk of all-cause mortality by 46%(adjusted HR:1.46, 95% CI:1.2–1.79, p < 0.001). Subgroup analysis showed that diabetes and prediabetes increased the risk of death mainly in patients without comorbidities. Conclusion Prediabetes accounts for more than one-third of the young adults undergoing CAG and was associated with an increased risk of all-cause mortality, active prevention strategy should be considered for these patients.

Association of prediabetes with clinical outcomes in patients with chronic coronary syndrome: a post hoc analysis of the ISCHEMIA and ISCHEMIA-CKD trials

“…While more data are needed to confirm this finding, our data could suggest that prediabetes is of greater clinical importance in men than in women, especially in those who are under 65 years. [ 26 ]…”

“…While more data are needed to confirm this finding, our data could suggest that prediabetes is of greater clinical importance in men than in women, especially in those who are under 65 years. [26] In the early 2000s, findings from the Diabetes Prevention Program Study showed that metformin reduces the onset of new diabetes in patients with prediabetes, which was believed to be of clinical importance [27]. A 20-year follow-up study, however, confirmed that the treatment of prediabetes with metformin did not translate into improved clinical outcomes, questioning its therapeutic use in prediabetes [28].…”

Prediabetes is Associated with Worse Long-Term Outcomes in Young Patients with Acute Coronary Syndrome

“…A retrospective study found that pre-DM was present in 36.5% of young patients undergoing CAG. 11 However, only few data are available concerning the prevalence of pre-DM in young patients with CAD. Prediabetes can enhance cardiovascular disease risk by 20% and is related to the increase of incidence of ACS.…”

“…A recent study found that pre-DM increased the risk of all-cause death in young individuals undergoing coronary angiography (CAG). 11 However, this association was not significant in those with CAD, acute myocardial infarction (AMI), or undergoing percutaneous coronary intervention (PCI) To date, there is a lack of insight into the relationship between pre-DM and long-term adverse prognosis in young ACS patients. Therefore, this study aimed to examine the impact of pre-DM assessed by FPG or HbA1c levels on the long-term prognosis of patients with new-onset ACS aged≤ 45 years.…”