HbA1c-based rather than fasting plasma glucose-based definitions of prediabetes identifies high-risk patients with angiographic coronary intermediate lesions: a prospective cohort study
Authors' conclusion
In this cohort of patients with intermediate coronary lesions not undergoing revascularization therapy, prediabetes based on the IEC-HbA1c definition was associated with increased MACE risk compared with NGT, and may assist in identifying high-risk patients who can benefit from early lifestyle intervention.
Study context
- Population
- Patients with intermediate angiographic coronary lesions not undergoing revascularization, Fuwai hospital (Beijing, China), followed-up 2013–2021
- Participants
- 1,532 patients
- Exposure
- Prediabetes vs normal glucose tolerance (NGT)
- Outcome
- MACE: composite of all-cause death, non-fatal MI and repeated revascularization therapy
- Follow-up
- Median 6.1 years
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
MACE
Prediabetes (IEC-HbA1c) vs NGTHazard ratio (95% CI)
Multivariate cox analysis
1.705(1.143–2.543)
After confounding adjustment
1.513(1.005–2.277)
- Major adverse cardiovascular events (MACE) events
- 197
Observational data: associations, not effects.
Further findings
Prevalence of prediabetes by definition
- Proportion defined as prediabetes, depending on definition
- 3.92% to 47.06%
Best HbA1c cut-off (Youden's index)
- Best HbA1c cut-off point
- 6%
- Linear positive relationship between baseline HbA1c and MACE risk (restricted cubic spline)
Original publication
HbA1c-based rather than fasting plasma glucose-based definitions of prediabetes identifies high-risk patients with angiographic coronary intermediate lesions: a prospective cohort study. Cardiovasc Diabetol. Published 25 March 2023. doi:10.
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