Prediabetes is not an independent risk factor for incident heart failure, other cardiovascular events or mortality in older adults: Findings from a population-based cohort study

Prakash Deedwania, Kanan Patel, Gregg C. Fonarow, Ravi V. Desai, Yan Zhang, Margaret A. Feller, Fernando Ovalle, Thomas E. Love, Inmaculada B. Aban, Marjan Mujib, Mustafa I. Ahmed, Stefan D. Anker, Ali Ahmed

Research output: Contribution to journalArticlepeer-review

Abstract

Background Whether prediabetes is an independent risk factor for incident heart failure (HF) in non-diabetic older adults remains unclear. Methods Of the 4602 Cardiovascular Health Study participants, age ≥ 65 years, without baseline HF and diabetes, 2157 had prediabetes, defined as fasting plasma glucose (FPG) 100-125 mg/dL. Propensity scores for prediabetes, estimated for each of the 4602 participants, were used to assemble a cohort of 1421 pairs of individuals with and without prediabetes, balanced on 44 baseline characteristics. Results Participants had a mean age of 73 years, 57% were women, and 13% African American. Incident HF occurred in 18% and 20% of matched participants with and without prediabetes, respectively (hazard ratio {HR} associated with prediabetes, 0.90; 95% confidence interval {CI}, 0.76-1.07; p = 0.239). Unadjusted and multivariable-adjusted HRs (95% CIs) for incident HF associated with prediabetes among 4602 pre-match participants were 1.22 (95% CI, 1.07-1.40; p = 0.003) and 0.98 (95% CI, 0.85-1.14; p = 0.826), respectively. Among matched individuals, prediabetes had no independent association with incident acute myocardial infarction (HR, 1.02; 95% CI, 0.81-1.28; p = 0.875), angina pectoris (HR, 0.93; 95% CI, 0.77-1.12; p = 0.451), stroke (HR, 0.86; 95% CI, 0.70-1.06; p = 0.151) or all-cause mortality (HR, 0.99; 95% CI, 0.88-1.11; p = 0.840). Conclusions We found no evidence that prediabetes is an independent risk factor for incident HF, other cardiovascular events or mortality in community-dwelling older adults. These findings question the wisdom of routine screening for prediabetes in older adults and targeted interventions to prevent adverse outcomes in older adults with prediabetes.

Original languageEnglish
Pages (from-to)3616-3622
Number of pages7
JournalInternational Journal of Cardiology
Volume168
Issue number4
DOIs
Publication statusPublished - Oct 9 2013

Keywords

  • Diabetes
  • Heart failure
  • Older adults
  • Prediabetes
  • Propensity-matched study

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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