Prognostic implications of fasting plasma glucose in subjects with echocardiographic abnormalities

Research output: Contribution to journalArticle

Abstract

Aims To examine whether baseline fasting plasma glucose (FPG) modifies the prognostic role of left ventricular (LV) mass, geometric pattern, and diastolic function, for prediction of cardiovascular morbidity and mortality. Methods Population-based cohort study comprising of 1047 men and 456 women with preserved ejection fraction, included between 2002 and 2006, who underwent echocardiography based on groups defined by FPG, measured prior to echocardiography. The clinical endpoint was the composite of cardiovascular events and all-cause mortality, assessed through national and local registries. Cox proportional-hazards regression with interaction analysis was used to evaluate the risk associated with FPG and LV structure and function. Results Median age was 67 years, and 31% had impaired fasting glucose, 31% diabetes, 17% LV hypertrophy, and 40% diastolic dysfunction. During a median follow-up duration of 8.3 years, 449 composite events occurred. FPG (hazard ratio (HR), 1.09 (95% confidence interval (CI): 1.05–1.13), P < 0.001) and several markers of LV structure and function, including LV mass index (HR, 1.10 (95% CI: 1.06–1.15), P < 0.001) and E/é (HR, 1.08 (95% CI 1.05–1.10), P < 0.001) were associated with an increased risk of events. In the subgroup of 678 individuals without previous cardiovascular disease, who did not receive cardiovascular, anti-diabetic, or lipid-lowering medication, FPG significantly interacted with the association between concentric LV hypertrophy and event risk (P < 0.001), and with the association between diastolic dysfunction and event risk (P = 0.02), including grade 2 or 3 dysfunction (P = 0.04). Conclusions Echocardiographic abnormalities were more strongly associated with an adverse prognosis among subjects with impaired fasting glucose or diabetes.

Details

Authors
Organisations
External organisations
  • Odense University Hospital
  • Skåne University Hospital
  • Brigham and Women's Hospital / Harvard Medical School
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Diabetes mellitus, Diastolic dysfunction, Impaired fasting glucose, Left ventricular hypertrophy
Original languageEnglish
Pages (from-to)423-429
Number of pages7
JournalInternational Journal of Cardiology
Volume241
Publication statusPublished - 2017 Aug 15
Publication categoryResearch
Peer-reviewedYes