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Meta-Analysis
. 2021 Nov;23(11):2476-2483.
doi: 10.1111/dom.14490. Epub 2021 Aug 2.

Association between prediabetes and adverse outcomes in heart failure

Linlin Mai  1 , Weixing Wen  1 , Min Qiu  1 , Xiong Liu  1 , Lichang Sun  1 , Haoxiao Zheng  1 , Xiaoyan Cai  2 , Yuli Huang  1   3   4
Affiliations
Meta-Analysis

Association between prediabetes and adverse outcomes in heart failure

Linlin Mai et al. Diabetes Obes Metab. 2021 Nov.

Abstract

Aims: Patients with heart failure (HF) and with diabetes experienced significantly worse outcomes than those without diabetes. However, data on the prognostic impact of prediabetes in HF are inconclusive. This meta-analysis aimed to explore the association between prediabetes and the risk of all-cause mortality and adverse cardiac outcomes in patients with HF.

Materials and methods: We searched multiple electronic databases (PubMed, Embase and Google Scholar) for relevant studies up to 31 March 2021. Studies were included for analysis if multivariable adjusted relative risks of adverse outcomes were reported in patients with prediabetes and with HF compared with those with normoglycaemia. Random-effects models were used to calculate the pooled hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: Twelve studies comprising 28 643 patients with HF reported the risk of all-cause mortality and cardiac outcomes associated with prediabetes. The prevalence of prediabetes ranged from 9.6% to 37.2%. After a median follow-up duration of 2.3 years, patients with HF and with prediabetes were associated with an increased risk of all-cause mortality (HR 1.29, 95% CI 1.06-1.58), cardiovascular mortality (HR 1.59, 95% CI 1.09-2.32), HF hospitalization (HR 1.33, 95% CI 1.09-1.61), all-cause mortality and/or HF hospitalization (HR 1.22, 95% CI 1.01-1.47), as well as cardiovascular mortality and/or HF hospitalization (HR 1.21, 95% CI 1.07-1.37).

Conclusions: Prediabetes is associated with a worse prognosis in patients with HF. Further risk stratification and effective treatment strategies are needed in patients with prediabetes and with HF to improve the prognosis.

Keywords: adverse outcome; heart failure; mortality; prediabetes; prognosis.

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References

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