Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 24-33
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.24
Prediabetes: An overlooked risk factor for major adverse cardiac and cerebrovascular events in atrial fibrillation patients
Rupak Desai, Nishanth Katukuri, Sumaja Reddy Goguri, Azra Kothawala, Naga Ruthvika Alle, Meena Kumari Bellamkonda, Debankur Dey, Sharmila Ganesan, Minakshi Biswas, Kuheli Sarkar, Pramoda Prattipati, Shaylika Chauhan
Rupak Desai, Independent Researcher, Independent Researcher, Atlanta, GA 30079, United States
Nishanth Katukuri, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55902, United States
Sumaja Reddy Goguri, Department of Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Telangana 505001, India
Azra Kothawala, Department of Medicine, Jawaharlal Nehru Medical College, Belgaum 590010, India
Naga Ruthvika Alle, Department of Medicine, Narayana Medical College, Andhra Pradesh, Nellore 524003, India
Meena Kumari Bellamkonda, Department of Medicine, Dr Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijaywada 521286, India
Debankur Dey, Department of Medicine, Medical College Kolkata, Kolkata 700073, India
Sharmila Ganesan, Department of Medicine, P.E.S. Institute of Medical Sciences and Research, Andhra Pradesh 517425, India
Minakshi Biswas, Department of Medicine, Shaheed Ziaur Rahman Medical College, Bogra 5800, Bangladesh
Kuheli Sarkar, Department of Medicine, College of Medicine and J.N.M Hospital, Kalyani 741235, India
Pramoda Prattipati, Department of Medicine, Jawaharlal Nehru Medical College India, Karnataka, Belagavi 590010, India
Shaylika Chauhan, Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States
Author contributions: Desai R investigation writing-original draft, visualization, writing-review and editing, investigation, formal analysis, administration, supervision; Katukuri N, Goguri SR, Kothawala A, Alle NR, Bellamkonda MK, Dey D, Ganesan S, Biswas M, Sarkar K, Prattipati P, writing-original draft; writing-review and editing, investigation, visualization; Chauhan S conceptualization, methodology, resources, writing original, draft; writing-review and editing, administration, supervision; all authors have read and approved the final manuscript.
Institutional review board statement: Not applicable, data is obtained from a publicly available data set, patient identifiers are not used.
Informed consent statement: Informed consent statement was not needed because the study was carried out on a publicly available data set without patient identifiers.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Participants consent was not obtained but the presented data are anonymized and risk of identification is low.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Shaylika Chauhan, FACP, MD, Clinical Assistant Professor (Honorary), Department of Internal Medicine, Geisinger Health System, No. 1000 E Mountain Blvd, Wikes-Barre, PA 18702, United States.
Received: September 25, 2023
Peer-review started: September 25, 2023
First decision: October 10, 2023
Revised: October 22, 2023
Accepted: December 15, 2023
Article in press: December 15, 2023
Published online: January 15, 2024
Research background

Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events (MACCE). This observational retrospective cohort study examines relationship between prediabetes and MACCE in patients with atrial fibrillation (AF).

Research motivation

The study aims to fill a knowledge gap by studying the connection between prediabetes and major cardiac and cerebrovascular events in AF patients. The goal is to better understand the risks and implications for clinical practice in managing prediabetes in this population.

Research objectives

Our objective is to investigate and establish a link between prediabetes and MACCE in patients with AF.

Research methods

Using National Inpatient Sample (2019) and relevant ICD-10 CM codes, hospitalizations with AF were categorized into groups with and without prediabetes, excluding diabetics. The primary outcome was MACCE (all-cause inpatient mortality, cardiac arrest including ventricular fibrillation, and stroke) in AF-related hospitalizations.

Research results

Key findings include: Prediabetes was present in 1.6% of AF-related hospitalizations. The prediabetes cohort was younger (median age 75 years) with a higher proportion of males, blacks, Hispanics, and Asians. Males had a stronger association between prediabetes and MACCE than females, and among different racial groups, Hispanics and Asians had a stronger association compared to whites and blacks. The prediabetes cohort with AF admissions had a higher rate of MACCE compared to the non-prediabetic cohort with an odds ratio of 1.34 and a 95% confidence interval of 1.26-1.42.

Research conclusions

This study highlights the relationship between prediabetes and MACCE in AF patients, therefore emphasizing the importance of further research, awareness as well as the importance of screening and managing prediabetes in AF patients to prevent MACCE.

Research perspectives

The research perspective is primarily epidemiological and clinical. It aims to understand the prevalence, risk factors, and clinical implications of prediabetes in the context of cardiovascular health.