PREDIABETES ASSOCIATED WITH AN INCREASE IN MAJOR ADVERSE CARDIOVASCULAR EVENTS
70th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Virtual, May 15-17, 2021.
Cardiovascular disease continues to be the leading cause of death in the United States of America. Major Adverse Cardiovascular Events (MACE), which includes cerebrovascular accident (CVA), myocardial infarction (MI), Unstable Angina and Acute Coronary Syndrome, are the cause of 1 in 4 deaths. Type II Diabetes Mellitus is a well-known major risk factor to the development of cardiovascular disease; however, the role of prediabetes is less certain.
This is a retrospective chart review performed at Beaumont Health System in Michigan, and included data collected between 2006 and 2020. A total of 25,829 patients were included in the study and split in 2 groups: prediabetes group and control group. Prediabetes group included individuals who were prediabetic and remained in the prediabetic range. Control group included patients that maintained a normal hemoglobin A1c during the study. All patients were followed over the 14-year study period. MACE was determined by querying ICD codes. Chi-Square analysis was used to compare the rate of MACE between the groups.
A total of 12,691 patients and 13,138 were included in the prediabetes and control group, respectively. The incidence of MACE in the prediabetes group (17.97%, 95% CI [17.3%, 18.63%]) was significantly higher than the MACE incidence observed in the control group (11.01%, 95% CI [10.48%,11.55%]) (p<0.0001).
Prediabetes is a clinical entity which appears to be associated with a significantly increased incidence of MACE. Clinicians should consider more aggressive risk factor modification in patients with prediabetes in an effort to prevent morbidity and mortality associated with MACE.