PREDIABETES IN STEMI PATIENTS – INCIDENCE AND POPULATION CHARACTERISTICS

Introduction. Prediabetes is a metabolic disease characterized by a disorder of glucose homeostasis. Despite the growing evidence of an increased risk of cardiovascular disease, pharmacological treatment of prediabetes is currently not universally recommended.
Objectives. To determine the proportion of patients with prediabetes in the group of patients with STEMI, to describe their characteristics and to compare them with the population of diabetes and without impaired glucose metabolism.
Methodology and results. The cohort consists of 2254 consecutive patients admitted to our clinic in 2012-2020 with the initial diagnosis of STEMI. According to glycated hemoglobin values and previous antidiabetic medication, patients were divided into three groups: patients with diabetes (N=604, 26.8%, Ø HbA1c = 62.9 ± 17.7mmol/mol), patients with prediabetes (N = 408, 18.1%, Ø HbA1c = 43.8 ± 1.6 mmol/mol) and patients without glucose metabolism disorders (N=1242, 55,1%, Ø HbA1c = 37.01 ± 3.0mmol/mol). We compared baseline charakteristics, laboratory values, LVEDP, LVEF and number of vessels with stenosis over 50%. The results are presented in the table.
Conclusion. Patients with prediabetes make up 18.1% of STEMI patients admitted to our clinic. Compared to patients without known disorders of glucose metabolism, patients with prediabetes showed significantly higher levels of urea, uric acid and CRP. Moreover, multivessel disease incidence and LVEF were similar to the diabetes subgroup. The prognosis of patients with prediabetes, including the risk of MI, PCI/CABG, stroke and mortality in comparison with diabetics and patients without impaired glucose metabolism will be the subject of the further study.