Abstract 13610: Examining Stroke in Metabolically Healthy Hospitalized Young Tobacco Users With Prediabetes: A Population-Based Analysis in the United States, 2019

Abstract

Introduction: Correlation between prediabetes and stroke risk among young, metabolically healthy tobacco users is unknown. Our research aims to explore this association. Methods: We did a retrospective study and extracted data from the 2019 National Inpatient Sample (NIS). Focusing on metabolically healthy (defined as absence of known cardiovascular disease risk factors, hypertension, diabetes mellitus, hyperlipidemia, and obesity) young adults aged 18-44 with tobacco use and prediabetes. Results: Our study of 1,017,540 hospital admissions of young, tobacco-using metabolically healthy individuals, identified 2,390 (0.2%) prediabetic cases. Compared to non-prediabetics, prediabetic patients were older, more often male, less frequently white, and had higher rates of comorbidities such as chronic obstructive pulmonary disease (19.2% vs. 11.7%), previous myocardial infarction (1.5% vs. 0.4%), and chronic kidney disease (2.5% vs. 0.9%). Clinical outcomes showed prediabetes was associated with higher rates of major adverse cardiac and cerebrovascular outcomes (MACE) (2.9% vs. 1.4%, p<0.001) and stroke (1.9% vs. 0.5%, p<0.001). After adjusting for confounders, prediabetes was still associated with increased stroke (aOR: 3.31, 95% CI: 1.67 - 6.55, p<0.001). The odds of MACE were higher but not significant (p=0.078). Stratifying by demographics, both sexes and all races except blacks for MACE (p=0.172) showed statistically significant higher rates of MACE and stroke in prediabetic patients. Those in lower household income with prediabetes also had higher rates of MACE and stroke (p=0.015 and p=0.001, respectively). Conclusion: There is almost a 3-fold escalation in stroke risk among prediabetic young, metabolically healthy tobacco users. These findings highlight the necessity of acknowledging prediabetes as a potent risk factor despite absent metabolic risk factors and prevailing income disparities.