Prediabetes Is Associated With Increased Risk of Heart Failure Among Patients With Atrial Fibrillation

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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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Jia-Yi Huang1,2, Yi-Kei Tse2, Hang-Long Li2

  • 1Division of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen Hospital, Hong Kong, China.

Diabetes Care
|October 17, 2022
PubMed

Insights

Prediabetes increases heart failure risk in atrial fibrillation patients. Progression to diabetes further elevates this risk, while reverting to normal blood sugar levels reduces it.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular risk.
  • Glycemic status, including prediabetes and diabetes, significantly impacts cardiovascular outcomes.
  • Understanding the interplay between AF, glycemic status, and heart failure (HF) is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the association between prediabetes and incident heart failure (HF) in patients with newly diagnosed atrial fibrillation (AF).
  • To examine the impact of changes in glycemic status (progression to diabetes or reversion to normoglycemia) on HF risk within the prediabetes cohort.

Main Methods:

  • A cohort of 17,943 patients with newly diagnosed AF (2015-2018) was categorized by baseline glycemic status: normoglycemia, prediabetes, or type 2 diabetes.
  • Incident HF was the primary outcome, analyzed using the Fine and Gray competing risks model, with death as a competing event.
  • Changes in glycemic status (progression/reversion) were assessed over 2 years in the prediabetes group.

Main Results:

  • Prediabetes at baseline was associated with a significantly increased risk of HF compared to normoglycemia (SHR 1.12).
  • Patients with prediabetes showed a higher incidence of HF (15.7%) compared to normoglycemic individuals (14%).
  • Within the prediabetes group, progression to diabetes increased HF risk (SHR 1.50), while reversion to normoglycemia decreased HF risk (SHR 0.61).

Conclusions:

  • Prediabetes is an independent risk factor for developing heart failure in patients with atrial fibrillation.
  • Changes in glycemic status significantly modify HF risk: progression to diabetes exacerbates risk, whereas normalization of blood glucose levels mitigates it.
  • These findings highlight the importance of monitoring and managing glycemic status in AF patients to prevent heart failure.
Abstract

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