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- Title
Incidence of Congestive Heart Failure in Patients with and without Impaired Fasting Glucose.
- Authors
Nichols, Gregory A.; Kolatkar, Nikheel S.; Koro, Carol E.
- Abstract
Clinical trials demonstrating that type 2 diabetes can be delayed or prevented have heightened interest in the epidemiology of diabetic complications that may begin in pre-diabetic stages of impaired glucose regulation. An association between milder states of impaired glucose regulation and congestive heart failure (CHF) has been reported in clinical trials, but has not been well studied in real-world settings. Using the electronic records of Kaiser Permanente Northwest, we identified 10,113 non-diabetic subjects with a fasting plasma glucose (FPG) test result between 100 and 125mg/dl in 1997 or 1998 and no prior history of CHF. We matched them on age, sex and FPG test-year to 10,113 patients with normal FPG test results and no history of CHF. Both groups were then followed until they experienced a hospitalization with a primary diagnosis of CHF, disenrollment from the heath care plan or 12/31/05, whichever came earlier. We calculated and compared CHF incidence rates in subjects with IFG compared to subjects with normal FPG levels, after adjusting for known risk factors. Subjects with impaired fasting glucose (IFG) experienced CHF at a rate of 9.5/1,000 person-years (p-y), compared to 7.6/1000p-y among normoglycemic patients (p<0.001). The incidence rate of CHF increased with baseline fasting glucose level_incidence rate was 8.6/1000p-y for subjects with FPG = 100-109mg/dL and 11.4/1000p-y among those with FPG 110-125 mg/dL. Among all subjects, each one mg/dL increase in FPG was associated with a 1.7% increase in the risk of CHF (HR 1.017, 95% CI 1.012-1.023). However, after adjustment for established CHF risk factors, the association between FPG level and incident CHF was not statistically significant. Age, cigarette smoking, presence of cardiovascular disease, BMI, blood pressure, and serum creatinine level were highly predictive of CHF. In contrast to other studies which have documented an independent relationship between IFG and risk of CHF, we observed that the higher incidence of CHF among patients with IFG compared to those with normoglycemia could be explained by other established CHF risk factors. Further work is needed to elucidate the relationship between impaired glucose homeostasis and the risk of CHF.
- Subjects
CONGESTIVE heart failure; GLUCOSE; DISEASE risk factors; HOMEOSTASIS; HEART failure
- Publication
Diabetes, 2007, Vol 56, pA34
- ISSN
0012-1797
- Publication type
Article