title: Prediabetes is not an independent risk factor for incident heart failure, other cardiovascular events or mortality in older adults: findings from a population-based cohort study.
abstract: BACKGROUND
  Whether prediabetes is an independent risk factor for incident heart failure (HF) in non-diabetic older adults remains unclear.
  
  
  METHODS
  Of the 4602 Cardiovascular Health Study participants, age≥65 years, without baseline HF and diabetes, 2157 had prediabetes, defined as fasting plasma glucose (FPG) 100-125 mg/dL. Propensity scores for prediabetes, estimated for each of the 4602 participants, were used to assemble a cohort of 1421 pairs of individuals with and without prediabetes, balanced on 44 baseline characteristics.
  
  
  RESULTS
  Participants had a mean age of 73 years, 57% were women, and 13% African American. Incident HF occurred in 18% and 20% of matched participants with and without prediabetes, respectively (hazard ratio {HR} associated with prediabetes, 0.90; 95% confidence interval {CI}, 0.76-1.07; p=0.239). Unadjusted and multivariable-adjusted HRs (95% CIs) for incident HF associated with prediabetes among 4602 pre-match participants were 1.22 (95% CI, 1.07-1.40; p=0.003) and 0.98 (95% CI, 0.85-1.14; p=0.826), respectively. Among matched individuals, prediabetes had no independent association with incident acute myocardial infarction (HR, 1.02; 95% CI, 0.81-1.28; p=0.875), angina pectoris (HR, 0.93; 95% CI, 0.77-1.12; p=0.451), stroke (HR, 0.86; 95% CI, 0.70-1.06; p=0.151) or all-cause mortality (HR, 0.99; 95% CI, 0.88-1.11; p=0.840).
  
  
  CONCLUSIONS
  We found no evidence that prediabetes is an independent risk factor for incident HF, other cardiovascular events or mortality in community-dwelling older adults. These findings question the wisdom of routine screening for prediabetes in older adults and targeted interventions to prevent adverse outcomes in older adults with prediabetes.
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Prakash
authors.initials: P
authors.lastname: Deedwania
authors.forename: Kanan
authors.initials: K
authors.lastname: Patel
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Desai
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Feller
authors.forename: Fernando
authors.initials: F
authors.lastname: Ovalle
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Love
authors.forename: Inmaculada B
authors.initials: IB
authors.lastname: Aban
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.forename: Mustafa I
authors.initials: MI
authors.lastname: Ahmed
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D011159:Population Surveillance / Q000379:methods; D011236:Prediabetic State / Q000175:diagnosis* / Q000401:mortality*; D012307:Risk Factors
keywords: Diabetes; Heart failure; Older adults; Prediabetes; Propensity-matched study