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- Title
Prediabetes Is Associated With Increased Risk of Heart Failure Among Patients With Atrial Fibrillation.
- Authors
Huang, Jia-Yi; Tse, Yi-Kei; Li, Hang-Long; Chen, Cong; Zhao, Chun-Ting; Liu, Ming-Ya; Wu, Mei-Zhen; Ren, Qing-Wen; Yu, Si-Yeung; Hung, Denise; Li, Xin-Li; Tse, Hung-Fat; Lip, Gregory Y.H.; Yiu, Kai-Hang
- Abstract
OBJECTIVE: To evaluate the association between prediabetes and heart failure (HF) and the association of HF with changes in glycemic status. RESEARCH DESIGN AND METHODS: Patients newly diagnosed with atrial fibrillation (AF) between 2015 and 2018 were divided into three groups (normoglycemia, prediabetes, and type 2 diabetes) according to their baseline glycemic status. The primary outcome was incident HF. The Fine and Gray competing risks model was applied, with death defined as the competing event. RESULTS: Among 17,943 patients with AF (mean age 75.5 years, 47% female), 3,711 (20.7%) had prediabetes, and 10,127 (56.4%) had diabetes at baseline. Over a median follow-up of 4.7 years, HF developed in 518 (14%) patients with normoglycemia, 646 (15.7%) with prediabetes, and 1,795 (17.7%) with diabetes. Prediabetes was associated with an increased risk of HF compared with normoglycemia (subdistribution hazard ratio [SHR] 1.12, 95% CI 1.03–1.22). In patients with prediabetes at baseline, 403 (11.1%) progressed to diabetes, and 311 (8.6%) reversed to normoglycemia at 2 years. Compared with remaining prediabetic, progression to diabetes was associated with an increased risk of HF (SHR 1.50, 95% CI 1.13–1.97), whereas reversion to normoglycemia was associated with a decreased risk (SHR 0.61, 95% CI 0.42–0.94). CONCLUSIONS: Prediabetes was associated with an increased risk of HF in patients with AF. Compared with patients who remained prediabetic, those who progressed to diabetes at 2 years experienced an increased risk of HF, whereas those who reversed to normoglycemia incurred a lower risk of HF.
- Subjects
HEART failure patients; ATRIAL fibrillation; PREDIABETIC state; TYPE 2 diabetes
- Publication
Diabetes Care, 2023, Vol 46, Issue 1, p190
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc22-1188