Hassan Khan1, Setor K Kunutsor2, Jussi Kauhanen3, Sudhir Kurl3, Eiran Z Gorodeski4, Amanda I Adler5, Javed Butler6, Jari A Laukkanen7. 1. Department of Public Health and Primary Care, University of Cambridge, United Kingdom. Electronic address: drhasankhan@gmail.com. 2. Department of Public Health and Primary Care, University of Cambridge, United Kingdom. 3. Kuopio Research Institute of Exercise Medicine, Kuopio, Finland. 4. Cleveland Clinic, Cleveland, Ohio. 5. Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom. 6. Emory University, Atlanta, Georgia. 7. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Internal Medicine, Lapland Central Hospital, Rovaniemi, Finland.
Abstract
BACKGROUND: There remains uncertainty regarding the association between fasting plasma glucose (FPG) and risk of heart failure (HF) in individuals without a history of diabetes. METHODS AND RESULTS: We assessed the association between FPG and HF risk in a population-based cohort of 1,740 men aged 42-61 years who were free from HF or diabetes at baseline. During a mean follow-up of 20.4 years, 146 participants developed HF. In age-adjusted analysis, the hazard ratio (HR) for HF per 1 mmol/L increase in FPG was 1.34 (95% confidence interval 1.22-1.48). This association persisted after adjusting for established HF risk factors: HR 1.27, 95% confidence interval 1.14-1.42. The findings remained consistent across several clinical subgroups and in analyses excluding incident coronary heart disease or diabetes during follow-up. In a meta-analysis of 10 prospective studies involving 4,213 incident HF cases, the HR for HF per 1 mmol/L increase in FPG level was 1.11 (95% confidence interval 1.04-1.17), with evidence of heterogeneity between studies (I(2) = 79%; 95% confidence interval 63%-89%; P < .001). The corresponding HR was 1.12 (95% confidence interval 1.08-1.18) on exclusion of the single study that accounted for the heterogeneity. CONCLUSIONS: There exists a positive, continuous, and independent association between FPG and risk for HF. Studies are warranted to evaluate the causal relevance of these findings.
BACKGROUND: There remains uncertainty regarding the association between fasting plasma glucose (FPG) and risk of heart failure (HF) in individuals without a history of diabetes. METHODS AND RESULTS: We assessed the association between FPG and HF risk in a population-based cohort of 1,740 men aged 42-61 years who were free from HF or diabetes at baseline. During a mean follow-up of 20.4 years, 146 participants developed HF. In age-adjusted analysis, the hazard ratio (HR) for HF per 1 mmol/L increase in FPG was 1.34 (95% confidence interval 1.22-1.48). This association persisted after adjusting for established HF risk factors: HR 1.27, 95% confidence interval 1.14-1.42. The findings remained consistent across several clinical subgroups and in analyses excluding incident coronary heart disease or diabetes during follow-up. In a meta-analysis of 10 prospective studies involving 4,213 incident HF cases, the HR for HF per 1 mmol/L increase in FPG level was 1.11 (95% confidence interval 1.04-1.17), with evidence of heterogeneity between studies (I(2) = 79%; 95% confidence interval 63%-89%; P < .001). The corresponding HR was 1.12 (95% confidence interval 1.08-1.18) on exclusion of the single study that accounted for the heterogeneity. CONCLUSIONS: There exists a positive, continuous, and independent association between FPG and risk for HF. Studies are warranted to evaluate the causal relevance of these findings.
Authors: Michael P Bancks; Mercedes R Carnethon; Lisa S Chow; Samuel S Gidding; David R Jacobs; Satoru Kishi; Joao Lima; Donald Lloyd-Jones; Jared P Reis; Pamela J Schreiner; Rachel Zmora; Norrina B Allen Journal: J Diabetes Complications Date: 2019-02-06 Impact factor: 3.219
Authors: Lotte Jacobs; Ljupcho Efremov; João Pedro Ferreira; Lutgarde Thijs; Wen-Yi Yang; Zhen-Yu Zhang; Roberto Latini; Serge Masson; Nera Agabiti; Peter Sever; Christian Delles; Naveed Sattar; Javed Butler; John G F Cleland; Tatiana Kuznetsova; Jan A Staessen; Faiez Zannad Journal: J Am Heart Assoc Date: 2017-05-02 Impact factor: 5.501