Prediabetes Not as Benign as Once Believed, Associated with Increased Risk of Heart Attacks


An analysis of the National Inpatient Sample details the statistically significant increases in the risk of experiencing myocardial infarction, PCI, or CABG in patients with prediabetes compared to their normoglycemic counterparts.

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New data from an analysis of the National Inpatient Sample (NIS) is providing clinicians with further insight into the cardiovascular risk associated with prediabetes.

Performed by investigators at Saint Peter’s University Hospital and Rutgers Robert Wood Johnson Medical School, results of the study suggest patients with prediabetes saw statistically significant increases in the likelihood of experiencing myocardial infarction, PCI, or CABG.

“Our study serves as a wake-up to everyone to shift the focus to managing prediabetes, not just diabetes,” said lead investigator Geethika Thota, MD, an internal medicine resident with Saint Peter’s Healthcare System, in a statement from the Endocrine Society. “Based on our findings, we encourage everyone to make lifestyle changes, follow a healthy diet and regularly exercise for at least 150 minutes each week in patients with prediabetes to decrease the risk of heart attacks.”

Although the growing number of patients with type 2 diabetes has dominated the media landscape in recent years, the epidemic of prediabetes has grown in stride but received less attention from both mainstream media outlets and as a research priority. As more data has emerged regarding the cardiovascular risk associated with prediabetes, a possible association between prediabetes and risk of myocardial infarction has risen as a research interest.

Thota and colleagues designed the current study as an analysis of data from the NIS. Using the NIS from 2016-2018, investigators identified a cohort of 1,794,149 (95% CI, 1,753,742-1,834,556) weighted hospitalizations with a primary or secondary diagnosis of myocardial infarction for inclusion in their analyses. For the purpose of analysis, investigators created 3 separate multivariate logistic regression models with myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting used as the outcomes of interest.

Initial analysis indicated prediabetes was associated with an increased likelihood of experiencing myocardial infarction (OR, 1.41 [95% CI, 1.35-1.47]; P=.0001). In analyses adjusted for age, sex, race, family history of myocardial infarction, dyslipidemia, hypertension, diabetes nicotine dependence, and obesity, results suggested pore diabetes was significantly associated with increased likelihood of myocardial infarction (OR, 1.25 [95% CI 1.20-1.31]; P=0.001), percutaneous coronary intervention (OR, 1.45 [95% CI 1.37-1.53]; P=0.001) and CABG (OR 1.95, [95% CI 1.77-2.16]; P=0.001).

“Our findings reinforce the importance of early recognition by screening and early intervention of prediabetes by lifestyle changes and/or medications to decrease the risk of cardiovascular events,” Thota added.

This study, “Prediabetes is a Risk Factor for Myocardial Infarction-A National Inpatient Sample Study,” was presented at ENDO 2022.

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