Abstract 13234: Prediabetes, an Important Predictor of Major Adverse Cardiac and Cerebrovascular Events in Atrial Fibrillation Patients: A National Inpatient Sample Analysis, 2019

Abstract

Background: Prediabetes is an established risk factor for major adverse cardiac and cerebrovascular events (MACCE). However, the association between prediabetes (pDM) and MACCE in atrial fibrillation (AF) patients remains understudied. We aim to establish a relation between prediabetes and MACCE in AF patients. Methods: Using the National Inpatient Sample (2019) and relevant ICD-10 codes, we identified hospitalizations with AF and categorized them into groups with and without pDM excluding diabetics. The primary outcome was MACCE (All-cause inpatient mortality, Cardiac Arrest including Ventricular Fibrillation, and Stroke) in AF-related hospitalizations. Results: Of 2,965,875 AF-related hospitalizations for MACCE, 47,505 (1.6%) were among pre-diabetics. The pDM cohort was relatively younger (median 75 vs 78 years), often consisted of males (56.3% vs 51.4%), blacks (9.8.% vs 7.9%), Hispanics (7.3% vs 4.3%), and API (4.7% vs 1.6%) than the nonprediabetic cohort (p<0.001). The pDM group often had significantly higher rates of HTN, hyperlipidemia, smoking, obesity, drug abuse, prior MI, PVD, and hyperthyroidism (all p<0.05). The pDM cohort was often discharged routinely (51.1% vs 41.1%) but more frequently required home health care (23.6% vs 21.0%) and had higher costs. After adjusting for baseline characteristics or comorbidities, pDM cohort with AF admissions showed higher rate and significantly higher odds of MACCE vs Non-pDM cohort (18.6% vs. 14.7%, OR 1.34, 95CI 1.26-1.42, p<0.001). On subgroup analyses, Males had stronger association (aOR 1.43) compared to females (aOR 1.22) whereas on race-wise comparison, Hispanics (aOR 1.43) and Asians (aOR 1.36) had stronger association with MACCE with pDM vs. whites (aOR 1.33) and blacks (aOR 1.21). Conclusions: We found a significant association between prediabetes and MACCE in AF patients. There is a need for further research to actively screen and manage pDM in AF to curtail MACCE.