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Prediabetes: An Overlooked but Important Predictor of Prognosis After Acute Myocardial Infarction
Session:
Sessão de Posters 56 - Risco metabólico e lipoproteínas na doença coronária
Speaker:
Catarina Lagoas Pohle
Congress:
CPC 2026
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Catarina Lagoas Pohle; Jéni Quintal; Patrícia Bernardes; Marco Cristo Tomaz; David Campos; Ivo Palmeiro; Catarina Sá; Filipe Seixo
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:"Avenir Book"">Background:</span></span></strong><br /> <span style="font-size:11pt"><span style="font-family:"Avenir Book"">Prediabetes is associated with heightened cardiovascular risk, yet its impact on outcomes after acute myocardial infarction (AMI) remains incompletely characterised. This study aimed to evaluate whether prediabetes is associated with an increased risk of a composite endpoint including all-cause mortality, heart failure (HF) hospitalization and recurrent myocardial infarction (MI).</span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:"Avenir Book"">Methods:</span></span></strong><br /> <span style="font-size:11pt"><span style="font-family:"Avenir Book"">We conducted a retrospective cohort study including 210 non-diabetic patients admitted with AMI from November 2021 to October 2022. HbA1c was measured at hospital admission, and prediabetes was defined according to HbA1c criteria (5.7–6.4%). Clinical characteristics, in-hospital outcomes and follow-up events were compared between patients with prediabetes and those with normal HbA1c. Kaplan–Meier survival curves were used to assess differences in event-free survival, and Cox proportional hazards models were performed to identify independent predictors of the composite outcome.</span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:"Avenir Book"">Results:</span></span></strong><br /> <span style="font-size:11pt"><span style="font-family:"Avenir Book"">A total of 210 patients were included (73.8% male; mean age 65±13 years), of whom 100 (47.6%) had prediabetes and 110 (42.4%) had normal HbA1c. Mean HbA1c was 5.2±0.2% in the normal HbA1c group and 5.9±0.1% in the prediabetes group. Baseline characteristics are shown in Table 1.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:"Avenir Book"">Prediabetes was significantly associated with new-onset left ventricular dysfunction (OR = 2.178; 95% CI: 1.167–4.064; p = 0.014). No significant association was observed with in-hospital mortality (OR = 4.54; 95% CI: 0.50–41.34; p = 0.194). However, Kaplan–Meier analysis showed significantly reduced composite event–free survival in prediabetic patients (log-rank = 7.229; p = 0.007). In the multivariable Cox regression model, prediabetes remained independently associated with the composite endpoint (HR = 2.389; 95% CI: 1.189–4.797; p = 0.014), even after adjustment for clinical variables.</span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:"Avenir Book"">Conclusion:</span></span></strong><br /> <span style="font-size:11pt"><span style="font-family:"Avenir Book"">Among non-diabetic patients admitted with AMI, prediabetes identified at admission was independently associated with a higher risk of adverse cardiovascular outcomes, driven by increased rates of new-onset left ventricular dysfunction and a significantly higher incidence of the composite endpoint. These findings support the importance of recognising prediabetes as a prognostic marker in the post-AMI setting.</span></span></span></span></span></p>
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