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
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
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DOI：
10.1016/j.ijcard.2013.05.038
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发表时间：
2013-10-09
影响因子：
3.5
通讯作者：
Ahmed, Ali
中科院分区：
文献类型：
--
作者：
Deedwania, Prakash;Patel, Kanan;Ahmed, Ali
背景资料：在4602名心血管健康研究参与者中，年龄= 65岁，没有基线HF和糖尿病，2157名患有前驱糖尿病，定义为空腹血浆葡萄糖（FPG）100- 125 mg/ dL。糖尿病前期的倾向分数，估计为每4602名参与者，被用来组装一个队列的1421对个人与无糖尿病前期，平衡44基线characteristics.Results：参与者的平均年龄为73岁，57%是女性，13%的非洲裔美国人。在有和没有前驱糖尿病的匹配参与者中，分别有18%和20%的人发生HF事件（前驱糖尿病相关的风险比{HR}，0.90; 95%置信区间{CI}，0.76- 1.07; p = 0.239）。在4602名匹配前参与者中，与糖尿病前期相关的HF事件的未校正和多变量校正HR（95%CI）分别为1.22（95%CI，1.07- 1.40; p = 0.003）和0.98（95%CI，0.85- 1.14; p = 0.826）。在匹配的个体中，糖尿病前期与急性心肌梗死事件无独立相关性（HR，1.02; 95% CI，0.81- 1.28; p = 0.875），心绞痛（HR，0.93; 95% CI，0.77- 1.12; p = 0.451），卒中（HR，0.86; 95% CI，0.70- 1.06; p = 0.151）或全因死亡（HR，0.99; 95%CI，0.88- 1.11; p = 0.840）.结论：我们没有发现糖尿病前期是社区居住老年人发生HF、其他心血管事件或死亡率的独立危险因素的证据。这些发现质疑老年人糖尿病前期常规筛查和有针对性的干预措施是否明智，以防止老年人糖尿病前期的不良后果。(C)2013爱思唯尔爱尔兰有限公司版权所有。
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. Amongmatched individuals, prediabetes had no independent associationwith incident acutemyocardial 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. (C) 2013 Elsevier Ireland Ltd. All rights reserved.