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Published in: Cardiovascular Diabetology 1/2023

Open Access 01-12-2023 | Angiography | Research

Prediabetes and all-cause mortality in young patients undergoing coronary artery angiography: a multicenter cohort study in China

Authors: Yibo He, Hongyu Lu, Yihang Ling, Jin Liu, Sijia Yu, Ziyou Zhou, Tian Chang, Yong Liu, Shiqun Chen, Jiyan Chen

Published in: Cardiovascular Diabetology | Issue 1/2023

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Abstract

Background

The prevalence of prediabetes is increasing in young adults and patients undergoing coronary angiography. However, whether prediabetes is a considerable risk factor for all-cause mortality remains undetermined in young patients undergoing coronary angiography.

Methods

In this study, we retrospectively included 8868 young patients (men aged < 45 years, women aged < 55 years) who underwent coronary angiography (CAG). Patients were categorized as normoglycemic, prediabetes and diabetes according to the HbA1c level or documented history of diabetes. The association of all-cause mortality with diabetes and prediabetes was detected by Cox proportional hazards regression analysis.

Results

A total of 3240 (36.5%) among 8868 young patients receiving CAG were prediabetes and 2218 (25.0%) were diabetes. 728 patients died during a median follow-up of 4.92 years. Compared to the normoglycemic group, prediabetes increased the risk of all-cause mortality in young CAG patients by 24%(adjusted HR: 1.24, 95% CI: 1.04–1.49, p = 0.019) and diabetes increased the risk of all-cause mortality by 46%(adjusted HR:1.46, 95% CI:1.2–1.79, p < 0.001). Subgroup analysis showed that diabetes and prediabetes increased the risk of death mainly in patients without comorbidities.

Conclusion

Prediabetes accounts for more than one-third of the young adults undergoing CAG and was associated with an increased risk of all-cause mortality, active prevention strategy should be considered for these patients.
Literature
1.
go back to reference Marx N, Davies MJ, Grant PJ, Mathieu C, Petrie JR, Cosentino F, et al. Guideline recommendations and the positioning of newer drugs in type 2 diabetes care. Lancet Diabetes Endocrinol. 2021;9(1):46–52.CrossRefPubMed Marx N, Davies MJ, Grant PJ, Mathieu C, Petrie JR, Cosentino F, et al. Guideline recommendations and the positioning of newer drugs in type 2 diabetes care. Lancet Diabetes Endocrinol. 2021;9(1):46–52.CrossRefPubMed
2.
go back to reference Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005–2016. JAMA Pediatr. 2020;174(2): e194498.CrossRefPubMed Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of prediabetes among adolescents and young adults in the United States, 2005–2016. JAMA Pediatr. 2020;174(2): e194498.CrossRefPubMed
3.
go back to reference Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW, et al. Mortality attributable to diabetes in 20–79 years old adults, 2019 estimates: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract. 2020;162: 108086.CrossRefPubMed Saeedi P, Salpea P, Karuranga S, Petersohn I, Malanda B, Gregg EW, et al. Mortality attributable to diabetes in 20–79 years old adults, 2019 estimates: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract. 2020;162: 108086.CrossRefPubMed
4.
go back to reference Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020;369: m997.CrossRefPubMedPubMedCentral Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020;369: m997.CrossRefPubMedPubMedCentral
5.
go back to reference Bullard KM, Saydah SH, Imperatore G, Cowie CC, Gregg EW, Geiss LS, et al. Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999–2010. Diabetes Care. 2013;36(8):2286–93.CrossRefPubMedPubMedCentral Bullard KM, Saydah SH, Imperatore G, Cowie CC, Gregg EW, Geiss LS, et al. Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999–2010. Diabetes Care. 2013;36(8):2286–93.CrossRefPubMedPubMedCentral
6.
go back to reference Wang JS, Lee IT, Lee WJ, Lin SY, Fu CP, Lee WL, et al. Comparing HbA1c, fasting and 2-h plasma glucose for screening for abnormal glucose regulation in patients undergoing coronary angiography. Clin Chem Lab Med. 2015;53(9):1441–9.CrossRef Wang JS, Lee IT, Lee WJ, Lin SY, Fu CP, Lee WL, et al. Comparing HbA1c, fasting and 2-h plasma glucose for screening for abnormal glucose regulation in patients undergoing coronary angiography. Clin Chem Lab Med. 2015;53(9):1441–9.CrossRef
7.
go back to reference Mata Marín LA, Schmucker J, Fach A, Osteresch R, Rühle S, Garstka D, et al. Prevalence and clinical characteristics of prediabetes and diabetes mellitus in young patients with ST-segment elevation myocardial infarction. Clin Res Cardiol. 2021;110(10):1647–58.CrossRefPubMed Mata Marín LA, Schmucker J, Fach A, Osteresch R, Rühle S, Garstka D, et al. Prevalence and clinical characteristics of prediabetes and diabetes mellitus in young patients with ST-segment elevation myocardial infarction. Clin Res Cardiol. 2021;110(10):1647–58.CrossRefPubMed
8.
go back to reference Park JS, Lee HJ, Kim YJ, Seong IW, Lee JW, Kim JJ, et al. The epidemiological and clinical characteristics of patients admitted for coronary angiography to evaluate ischemic heart disease. Korean J Intern Med. 2007;22(2):87–92.CrossRefPubMedPubMedCentral Park JS, Lee HJ, Kim YJ, Seong IW, Lee JW, Kim JJ, et al. The epidemiological and clinical characteristics of patients admitted for coronary angiography to evaluate ischemic heart disease. Korean J Intern Med. 2007;22(2):87–92.CrossRefPubMedPubMedCentral
9.
go back to reference Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016;355: i5953.CrossRefPubMedPubMedCentral Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ. 2016;355: i5953.CrossRefPubMedPubMedCentral
10.
go back to reference Park KS, Hwang SY. Lifestyle-related predictors affecting prediabetes and diabetes in 20–30-year-old young Korean adults. Epidemiol Health. 2020;42: e2020014.CrossRefPubMedPubMedCentral Park KS, Hwang SY. Lifestyle-related predictors affecting prediabetes and diabetes in 20–30-year-old young Korean adults. Epidemiol Health. 2020;42: e2020014.CrossRefPubMedPubMedCentral
11.
go back to reference Liu X, Wu S, Song Q, Wang X. Reversion from pre-diabetes mellitus to normoglycemia and risk of cardiovascular disease and all-cause mortality in a Chinese population: a prospective cohort study. J Am Heart Assoc. 2021;10(3): e019045.CrossRefPubMedPubMedCentral Liu X, Wu S, Song Q, Wang X. Reversion from pre-diabetes mellitus to normoglycemia and risk of cardiovascular disease and all-cause mortality in a Chinese population: a prospective cohort study. J Am Heart Assoc. 2021;10(3): e019045.CrossRefPubMedPubMedCentral
12.
go back to reference Rhee EJ, Jung I, Kwon H, Park SE, Kim YH, Han KD, et al. Increased mortality burden in young asian subjects with dysglycemia and comorbidities. J Clin Med. 2020;9(4):1042.CrossRefPubMedPubMedCentral Rhee EJ, Jung I, Kwon H, Park SE, Kim YH, Han KD, et al. Increased mortality burden in young asian subjects with dysglycemia and comorbidities. J Clin Med. 2020;9(4):1042.CrossRefPubMedPubMedCentral
13.
go back to reference Kiviniemi AM, Lepojärvi ES, Tulppo MP, Piira OP, Kenttä TV, Perkiömäki JS, et al. Prediabetes and risk for cardiac death among patients with coronary artery disease: the ARTEMIS study. Diabetes Care. 2019;42(7):1319–25.CrossRefPubMed Kiviniemi AM, Lepojärvi ES, Tulppo MP, Piira OP, Kenttä TV, Perkiömäki JS, et al. Prediabetes and risk for cardiac death among patients with coronary artery disease: the ARTEMIS study. Diabetes Care. 2019;42(7):1319–25.CrossRefPubMed
14.
go back to reference Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323.CrossRefPubMed Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323.CrossRefPubMed
15.
go back to reference Welsh C, Welsh P, Celis-Morales CA, Mark PB, Mackay D, Ghouri N, et al. Glycated hemoglobin, prediabetes, and the links to cardiovascular disease: data from UK biobank. Diabetes Care. 2020;43(2):440–5.CrossRefPubMed Welsh C, Welsh P, Celis-Morales CA, Mark PB, Mackay D, Ghouri N, et al. Glycated hemoglobin, prediabetes, and the links to cardiovascular disease: data from UK biobank. Diabetes Care. 2020;43(2):440–5.CrossRefPubMed
16.
go back to reference Zhang X, Wu H, Fan B, Shi M, Lau ESH, Yang A, et al. The role of age on the risk relationship between prediabetes and major morbidities and mortality: analysis of the Hong Kong diabetes surveillance database of 2 million Chinese adults. Lancet Reg Health West Pac. 2023;30: 100599.CrossRefPubMed Zhang X, Wu H, Fan B, Shi M, Lau ESH, Yang A, et al. The role of age on the risk relationship between prediabetes and major morbidities and mortality: analysis of the Hong Kong diabetes surveillance database of 2 million Chinese adults. Lancet Reg Health West Pac. 2023;30: 100599.CrossRefPubMed
17.
go back to reference Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS, et al. Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63(11):2305–14.CrossRefPubMed Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS, et al. Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63(11):2305–14.CrossRefPubMed
18.
go back to reference Islam Z, Akter S, Inoue Y, Hu H, Kuwahara K, Nakagawa T, et al. Prediabetes, diabetes, and the risk of all-cause and cause-specific mortality in a Japanese working population: Japan epidemiology collaboration on occupational health study. Diabetes Care. 2021;44(3):757–64.CrossRefPubMedPubMedCentral Islam Z, Akter S, Inoue Y, Hu H, Kuwahara K, Nakagawa T, et al. Prediabetes, diabetes, and the risk of all-cause and cause-specific mortality in a Japanese working population: Japan epidemiology collaboration on occupational health study. Diabetes Care. 2021;44(3):757–64.CrossRefPubMedPubMedCentral
19.
go back to reference Tang O, Matsushita K, Coresh J, Sharrett AR, McEvoy JW, Windham BG, et al. Mortality implications of prediabetes and diabetes in older adults. Diabetes Care. 2020;43(2):382–8.CrossRefPubMed Tang O, Matsushita K, Coresh J, Sharrett AR, McEvoy JW, Windham BG, et al. Mortality implications of prediabetes and diabetes in older adults. Diabetes Care. 2020;43(2):382–8.CrossRefPubMed
20.
go back to reference Cao Q, Xin Z, He R, Wang T, Xu M, Lu J, et al. Age-specific difference in the association between prediabetes and subclinical atherosclerosis: an analysis of a chinese prospective cohort study. Cardiovasc Diabetol. 2022;21(1):153.CrossRefPubMedPubMedCentral Cao Q, Xin Z, He R, Wang T, Xu M, Lu J, et al. Age-specific difference in the association between prediabetes and subclinical atherosclerosis: an analysis of a chinese prospective cohort study. Cardiovasc Diabetol. 2022;21(1):153.CrossRefPubMedPubMedCentral
21.
go back to reference Deedwania P, Patel K, Fonarow GC, Desai RV, Zhang Y, Feller MA, et al. 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. Int J Cardiol. 2013;168(4):3616–22.CrossRefPubMedPubMedCentral Deedwania P, Patel K, Fonarow GC, Desai RV, Zhang Y, Feller MA, et al. 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. Int J Cardiol. 2013;168(4):3616–22.CrossRefPubMedPubMedCentral
22.
go back to reference Huang YQ, Liu L, Huang JY, Chen CL, Yu YL, Lo K, et al. Prediabetes and risk for all-cause and cardiovascular mortality based on hypertension status. Ann Transl Med. 2020;8(23):1580.CrossRefPubMedPubMedCentral Huang YQ, Liu L, Huang JY, Chen CL, Yu YL, Lo K, et al. Prediabetes and risk for all-cause and cardiovascular mortality based on hypertension status. Ann Transl Med. 2020;8(23):1580.CrossRefPubMedPubMedCentral
24.
go back to reference International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327–34.CrossRef International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327–34.CrossRef
25.
go back to reference Warren B, Pankow JS, Matsushita K, Punjabi NM, Daya NR, Grams M, et al. Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2017;5(1):34–42.CrossRefPubMed Warren B, Pankow JS, Matsushita K, Punjabi NM, Daya NR, Grams M, et al. Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2017;5(1):34–42.CrossRefPubMed
26.
go back to reference Ali MK, Bullard KM, Saydah S, Imperatore G, Gregg EW. Cardiovascular and renal burdens of prediabetes in the USA: analysis of data from serial cross-sectional surveys, 1988–2014. Lancet Diabetes Endocrinol. 2018;6(5):392–403.CrossRefPubMedPubMedCentral Ali MK, Bullard KM, Saydah S, Imperatore G, Gregg EW. Cardiovascular and renal burdens of prediabetes in the USA: analysis of data from serial cross-sectional surveys, 1988–2014. Lancet Diabetes Endocrinol. 2018;6(5):392–403.CrossRefPubMedPubMedCentral
27.
go back to reference Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370: m2297.CrossRefPubMedPubMedCentral Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370: m2297.CrossRefPubMedPubMedCentral
28.
go back to reference Maroszyńska-Dmoch EM, Wożakowska-Kapłon B. Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study. Kardiol Pol. 2016;74(4):314–21.CrossRefPubMed Maroszyńska-Dmoch EM, Wożakowska-Kapłon B. Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study. Kardiol Pol. 2016;74(4):314–21.CrossRefPubMed
29.
go back to reference Juan-Salvadores P, Jiménez Díaz VA, Iglesia Carreño C, Guitián González A, Veiga C, Martínez Reglero C, et al. Coronary artery disease in very young patients: analysis of risk factors and long-term follow-up. J Cardiovasc Dev Dis. 2022;9(3):82.CrossRefPubMed Juan-Salvadores P, Jiménez Díaz VA, Iglesia Carreño C, Guitián González A, Veiga C, Martínez Reglero C, et al. Coronary artery disease in very young patients: analysis of risk factors and long-term follow-up. J Cardiovasc Dev Dis. 2022;9(3):82.CrossRefPubMed
30.
go back to reference Faisal AWK, Habib G, Yasmin S, Latif W, Ahmed S. Angiographic patterns of coronary artery disease in young patients presenting at a tertiary cardiac center. Pak J Med Sci. 2022;38(8):2107–11.PubMedPubMedCentral Faisal AWK, Habib G, Yasmin S, Latif W, Ahmed S. Angiographic patterns of coronary artery disease in young patients presenting at a tertiary cardiac center. Pak J Med Sci. 2022;38(8):2107–11.PubMedPubMedCentral
Metadata
Title
Prediabetes and all-cause mortality in young patients undergoing coronary artery angiography: a multicenter cohort study in China
Authors
Yibo He
Hongyu Lu
Yihang Ling
Jin Liu
Sijia Yu
Ziyou Zhou
Tian Chang
Yong Liu
Shiqun Chen
Jiyan Chen
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2023
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-023-01776-w

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