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CARDIOVASCULAR PROGNOSTIC FACTORS IN PREDIABETIC PATIENTS WITHIN A HYPERTENSIVE POPULATION

Carretero, R., Garcia1; Ruiz, C., Soguero2; Jimenez, I., Mora2; Medina, L., Vigil1

Journal of Hypertension: June 2018 - Volume 36 - Issue - p e25
doi: 10.1097/01.hjh.0000539029.61802.af
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Objective: Prediabetes is a major risk for development of type 2 diabetes, but it is unclear whether it increases the risk for cardiovascular disease (CVD). Our aim was to determine whether prediabetic patients was a a higher risk of CVD than non-prediabetic patients in our hypertensive population.

Design and method: We conducted a longitudinal, retrospective research with patients attended at a Hypertension Unit. Prediabetes was defined according to American Diabetes Association (ADA) criteria. Our primary outcome was a composite of non-fatal coronary disease, non-fatal stroke, heart failure and cardiovascular (CV) death. We fitted survival analysis using a Cox proportional hazard regression model to estimate the survival and time-to-event rates in prediabetic patients compared to non-prediabetic ones.

Results: We selected 1,652 patients, 713 (43%) with prediabetes (table 1). We encoded 13 cases of coronary disease, 26 strokes, 5 cases of heart failure and 27 CV deaths in the prediabetes cohort, and 16 cases of coronary disease, 18 strokes, 14 cases of heart failure and 14 CV deaths in the non-prediabetic group. The risk of developing a CV event was higher in the prediabetic patients (HR = 1.61, 95% CI 1.01- 2.54, p = 0.04), as shown in Figure 1. In a multivariate Cox survival analysis, age and cystatin C were the most relevant prognostic factors within the potential studied predictors (table 2).

Conclusions: Prediabetes was associated with a higher risk of CV event in prediabetic patients than non-prediabetic individuals from our hypertensive population. Cystatin C, along with age, was a major prognostic factor for CV risk, and can be useful in the risk asessment in prediabetic, hypertensive patients.

1Mostoles University Hospital, Mostoles, Spain

2Rey Juan Carlos University, Fuenlabrada, Spain

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