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

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

Source：Cardiovascular Diabetology, 2023, 22(1): 42.

DOI：10.1186/s12933-023-01776-w

• Coronary artery angiography
• Mortality
• Prediabetes
• Young adults

BackgroundThe 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.MethodsIn 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.ResultsA 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.ConclusionPrediabetes 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.

• Institution
  广东省人民医院; 广东省心血管病研究所; 南方医科大学; y