Association between prediabetes and adverse outcomes in heart failure
Heart failure in patients with diabetes results in severe outcomes as compared to non-diabetic. However, there is no conclusive data to suggest the prognostic impact of prediabetes on HF. Linlin Mai and colleagues conducted research under the title “ Association between prediabetes and adverse outcomes in heart failure” in Diabetes, Obesity, and Metabolism journal. The summary of this article is given below:
Objective:
To investigate the relationship between prediabetes and the risk of all-cause mortality and adverse cardiac outcomes in HF patients.
Method:
Relevant studies published before 31st March’2021 were selected through multiple electronic databases such as google scholar, PubMed, Embase. Studies were included for analysis if multivariable-adjusted relative risks of adverse outcomes were found in patients with prediabetes and with HF compared with those with normoglycemia. With the help of random-effects models, the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.
Findings:
The study reports that prediabetes in HF patients results in worse outcomes including a higher risk of all-cause mortality, cardiovascular mortality, and HF hospitalization, despite adjusting multiple potential cofounders. It is suggested that regular screening of blood glucose dysregulation in patients with HF without known DM will help in timely managing the adverse outcomes in HF with preventive strategies. Additionally, IGT was found to elevate the risk of adverse outcomes in patients with chronic HF when complicated by albuminuria.
Investigators suggest optimal management of prediabetes in order to prevent complications of HF.
Limitation:
There was a varied definition of prediabetes in different studies. Secondly, the pathophysiology of the effect of prediabetes on HF was not clear in any study. Most of the studies reviewed have defined prediabetes based on the admission metrics, hence there is a chance of this being ‘stress-induced hyperglycemia’, rather than real intermediate hyperglycemia.
Authors acknowledge future studies to investigate the prognosis of HF in patients with a different definition of prediabetes.
Image Credit : Heart photo created by jcomp – www.freepik.com