scholarly journals Impaired fasting glucose: a risk factor for atrial fibrillation and heart failure

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Viktor Lind ◽  
Niklas Hammar ◽  
Pia Lundman ◽  
Leif Friberg ◽  
Mats Talbäck ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Undiagnosed Diabetes ◽  
Glucose Levels ◽  
Hazard Ratios ◽  
Normal Glucose ◽  
Diagnosed Diabetes

Abstract Background Dysglycaemia is associated with overall cardiovascular disease even at prediabetes levels. The aim of this study was to explore the association between glucose levels and future risk of developing atrial fibrillation and heart failure, respectively. Methods In this prospective cohort study subjects from the Swedish AMORIS-cohort with fasting glucose from health examinations 1985–1996 without previous cardiovascular disease (N = 294,057) were followed to 31 December 2011 for incident atrial fibrillation or heart failure. Cox proportional hazard models with attained age as timescale and adjustments for sex, cholesterol, triglycerides, and socioeconomic status were used to estimate hazard ratios by glucose categorized groups (normal glucose 3.9–6.0 mmol/L, impaired fasting glucose; 6.1–6.9 mmol/L, undiagnosed diabetes ≥ 7.0 mmol/L, and diagnosed diabetes). Results During a mean follow-up time of 19.1 years 28,233 individuals developed atrial fibrillation and 25,604 developed heart failure. The HR for atrial fibrillation was 1.19 (95% confidence interval 1.13–1.26) for impaired fasting glucose, 1.23 (1.15–1.32) for undiagnosed diabetes and 1.30 (1.21–1.41) for diagnosed diabetes. Corresponding figures for heart failure were; 1.40 (1.33–1.48), 2.11 (1.99–2.23), 2.22 (2.08–2.36) respectively. In a subset with BMI data (19%), these associations were attenuated and for atrial fibrillation only remained statistically significant among subjects with diagnosed diabetes (HR 1.25; 1.02–1.53). Conclusions Fasting glucose at prediabetes levels is associated with development of atrial fibrillation and heart failure. To some extent increased BMI may drive this association.

4949Diverging secular trends in cardiovascular disease 21-year incidence in Swedish men born in 1950–1978

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Aberg ◽  
M Adiels ◽  
M Lindgren ◽  
J Nyberg ◽  
G Kuhn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Military Service ◽  
Secular Trends ◽  
Longitudinal Change ◽  
Medical Society ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models

Abstract Background Cardiovascular disease (CVD) mortality is decreasing in Western countries, including Sweden. However, there are reports of increases in incidence in young people with respect to heart failure (HF) and atrial fibrillation (AF). The magnitude and causes of these changes are only partly known. Aims We investigated secular trends in incidence in CVD outcomes and their attenuation by changes in body mass index (BMI). The outcomes were risk of acute myocardial infarction (AMI), heart failure (HF) and atrial fibrillation (AF) as well as cardiovascular and all-cause death in a population of Swedish adolescents. Methods We followed a cohort of Swedish men enrolled for military service conscription in 1969–1996 (n=1,326,082; mean age=18.3) until December 2016, collected from the national inpatient (IPR) and outpatient registries (OPR). Cox-proportional hazard models were used to analyse the longitudinal change in incidence by with respect to early (0–21 years) of follow-up for subgroups with conscription 1968–1971, 1971–1976, 1976–1981, 1981–1986, 1986–1991, 1991–1996 (with the group born 1971–1976 as reference). Adjustments for potential confounders including BMI were performed. Results We found that CVD and all-cause mortality and MI decreased progressively during the follow-up with hazard ratios (HR) of 0.51, 95% confidence interval (CI) 0.43–0.62, HR 0.51 CI 0.57–0.62, and 0.60 CI 0.50–0.72, respectively. In contrast, we found increases in the incidence of HF (HR 1.86, CI 1.48–2.33], and AF (HR 8.26, CI 6.87–9.92). Adjustments for changes in BMI partly attenuated the changes in secular trends. Cubic spline models showed where the changes in secular trends were most prominent. Conclusion The incidences of cardiovascular outcomes show diverging secular changes. While MI and cardiovascular mortality are continually decreasing, there is an increase in HF and AF. The associations appear to be partly explained by changes in index BMI over time. Acknowledgement/Funding grants from the Swedish Government and the county councils, the ALF–GBG-719761, ALFGBG-751111, Swedish Stroke Association, Göteborg Medical Society

Prevalence of lower extremity diseases associated with normal glucose levels, impaired fasting glucose, and diabetes among U.S. adults aged 40 or older

2007 ◽  
Vol 77 (3) ◽  
pp. 485-488 ◽  
Author(s):  
Edward W. Gregg ◽  
Qiuping Gu ◽  
Desmond Williams ◽  
Nathalie de Rekeneire ◽  
Yiling J. Cheng ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Glucose Levels ◽  
Normal Glucose

Abstract 3683: Gender Difference in the Impact of Fasting Serum Glucose Level on Risk of Coronary Heart Disease: Korea Medical Insurance Corporation Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Song Vogue Ahn ◽  
Hyeon Chang Kim ◽  
Chung Mo Nam ◽  
Hyun Chul Lee ◽  
Il Suh
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Serum Glucose ◽  
Fasting Serum ◽  
Fasting Serum Glucose ◽  
Glucose Levels ◽  
Hazard Ratios ◽  
The Impact

Objective: Diabetic women have a greater relative risk of coronary heart disease than diabetic men. However, gender difference in the impact of blood glucose levels below diabetic range on risk of coronary heart disease is unclear. The aim of this study is to evaluate whether the association between nondiabetic blood glucose levels and the incident risk of coronary heart disease is different in men and women. Methods: We measured fasting serum glucose levels and other cardiovascular risk factors in 172,580 Koreans (108,461 men and 64,119 women), aged 35–59 years in 1990 and 1992. Our primary outcomes were hospital admissions and deaths from coronary heart disease in 11 year follow-up from 1993 to 2003. Cox proportional hazard models were used to estimate the hazard ratios for coronary heart disease according to the baseline fasting serum glucose levels, after adjustment for age, body mass index, blood pressure, total cholesterol level, and cigarette smoking. Results: During the 11 years, 3,769 coronary heart disease events occurred. Risk of coronary heart disease in men was significantly increased at fasting serum glucose levels of diabetic range (≥ 126 mg/dL), although risk of coronary heart disease in women was significantly increased from impaired fasting glucose levels ≥ 110 mg/dL. In fasting serum glucose levels ≥ 110 mg/dL, the hazard ratios for coronary heart disease incidence were higher in women than in men compared with women and men with fasting glucose levels <80mg/dL, respectively. There was no association between impaired fasting glucose from 100 to 109 mg/dL and risk of coronary heart disease neither in men nor in women. Conclusions: The stronger impact of fasting serum glucose levels on relative risk of coronary heart disease in women compared with in men was significant from impaired fasting glucose levels ≥ 110 mg/dL. Adjusted Hazard Ratios (HRs) for Coronary Heart Disease by Fasting Serum Glucose Levels

209Glucose is associated with future atrial fibrillation and heart failure already at prediabetes levels, a 19 year follow up of 243,665 subjects

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Lind ◽  
N Hammar ◽  
P Lundman ◽  
L Friberg ◽  
M Tallback ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Glucose Level ◽  
Life Style ◽  
Fasting Glucose ◽  
Diabetes Diagnosis ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
Life Style Changes

Abstract Background Dysglycaemia is associated with cardiovascular disease even below the diagnostic diabetes threshold. Atrial fibrillation (AF) has been found to be associated with the metabolic syndrome and life-style changes after AF have been found to reduce recurrence of AF. Purpose We explored the association glucose and risk of first event of AF, HF and combined event. Methods Subject with fasting glucose in the AMORIS cohort, obtained 1985–1996 at routine occupational health check-ups or primary care in the Stockholm area were included. Subjects with prevalent AF, HF, ischemic heart disease, revascularization and cerebrovascular disease were excluded. Glucose levels were categorised as low (<3.9 mmol/L), normal (3.9–6.0mmol/L), impaired (IFG; 6.1–6.9 mmol/L) and diabetes (≥7.0 mmol/L or a diabetes diagnosis) according to WHO definition in 2006. First events of AF, HF or a combined event was identified until December 2011 by linkage to national registries. Information on co-morbidities was obtained from the National Patient Register. Hazard ratios (HR and 95% CI) by glucose group for AF and heart failure were calculated using Cox proportional hazards with attained age as timescale and adjusting for gender, total cholesterol and triglycerides. The change in AF risk by increasing glucose level was described by using splines (Figure). Results 243 665 subjects with mean age 48.3 at index date, 54% male were included. During a mean follow-up time of 19.1 years and 4,7 million person years, 23 522 events of AF, 21 411 events of HF and 35 131 combined events occurred. The proportion with IFG and diabetes were 3.2% and 3.3% respectively. In the diabetes group about half were diagnosed prevalent cases (1.5%). Glucose was continuously associated with developement of AF (Table and Figure) and even more of HF (Table). Events (n) and HR by glucose category Atrial fibrillation Heart failure Combined event Event HR [95% CI] Event HR [95% CI] Event HR [95% CI] Low 405 0.97 [0.88–1.08] 326 0.97 [0.87–1.08] 598 1.00 [0.92–1.09] Normal 20 663 1.00 17 811 1.00 30 159 1.00 IFG 1185 1.20 [1.13–1.28] 1319 1.43 [1.35–1.51] 1901 1.30 [1.24–1.36] Diabetes 1269 1.28 [1.20–1.35] 1955 2.19 [2.08–2.29] 2473 1.73 [1.66–1.81] Events (n) of AF, HF and combined and HR (95% CI) by fasting glucose category. HR for AF by glucose level spline graph Conclusion Dysglycaemia, including glucose levels below the diabetes threshold, is continuously associated with future risk of both AF and HF. These data are important considering the large population with undetected dysglycaemia at risk for AF and HF where preventive measures including life-style changes could be of importance even before the onset of overt diabetes. Acknowledgement/Funding Swedish Heart and Lung foundation

scholarly journals Association of Lipoprotein (a) variants with risk of cardiovascular disease: a Mendelian randomization study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Xia ◽  
Chunyue Guo ◽  
Kuo Liu ◽  
Yunyi Xie ◽  
Han Cao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Chinese Population ◽  
Left Ventricular Mass Index ◽  
Mendelian Randomization ◽  
Left Ventricular ◽  
Han Chinese ◽  
Han Chinese Population ◽  
Internal Dimension

Abstract Background There is a well-documented empirical relationship between lipoprotein (a) [Lp(a)] and cardiovascular disease (CVD); however, causal evidence, especially from the Chinese population, is lacking. Therefore, this study aims to estimate the causal association between variants in genes affecting Lp(a) concentrations and CVD in people of Han Chinese ethnicity. Methods Two-sample Mendelian randomization analysis was used to assess the causal effect of Lp(a) concentrations on the risk of CVD. Summary statistics for Lp(a) variants were obtained from 1256 individuals in the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei. Data on associations between single-nucleotide polymorphisms (SNPs) and CVD were obtained from recently published genome-wide association studies. Results Thirteen SNPs associated with Lp(a) levels in the Han Chinese population were used as instrumental variables. Genetically elevated Lp(a) was inversely associated with the risk of atrial fibrillation [odds ratio (OR), 0.94; 95% confidence interval (95%CI), 0.901–0.987; P = 0.012)], the risk of arrhythmia (OR, 0.96; 95%CI, 0.941–0.990; P = 0.005), the left ventricular mass index (OR, 0.97; 95%CI, 0.949–1.000; P = 0.048), and the left ventricular internal dimension in diastole (OR, 0.97; 95%CI, 0.950–0.997; P = 0.028) according to the inverse-variance weighted method. No significant association was observed for congestive heart failure (OR, 0.99; 95% CI, 0.950–1.038; P = 0.766), ischemic stroke (OR, 1.01; 95%CI, 0.981–1.046; P = 0.422), and left ventricular internal dimension in systole (OR, 0.98; 95%CI, 0.960–1.009; P = 0.214). Conclusions This study provided evidence that genetically elevated Lp(a) was inversely associated with atrial fibrillation, arrhythmia, the left ventricular mass index and the left ventricular internal dimension in diastole, but not with congestive heart failure, ischemic stroke, and the left ventricular internal dimension in systole in the Han Chinese population. Further research is needed to identify the mechanism underlying these results and determine whether genetically elevated Lp(a) increases the risk of coronary heart disease or other CVD subtypes.

scholarly journals Association of a Self-Paid Medically Supervised Weight Management Program with Reversal of Obesity-Associated Impaired Fasting Glucose

2021 ◽  
Vol 11 (2) ◽  
pp. 386-394
Author(s):  
Vijaya Surampudi ◽  
Xinkai Zhou ◽  
Chi-Hong Tseng ◽  
David Heber ◽  
Zhaoping Li
Keyword(s):  
Weight Loss ◽  
Blood Glucose ◽  
Retrospective Analysis ◽  
Weight Management ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Management Program ◽  
Weight Management Program ◽  
Glucose Levels

Aims: The progression of prediabetes to T2DM can be delayed through diet modification and weight management. However, the intensive lifestyle program is often not covered by medical insurance. This retrospective analysis evaluates the association of a patient self-paid weight management program on an improvement of blood sugar in overweight and obese patients with impaired fasting glucose (IFG). Methods: The medical records of 4634 patients who participated in the self-pay UCLA Weight Management Program were reviewed and 2572 patients met the criteria for this retrospective analysis to examine whether this program was associated with the reversal of IFG over 3 months among 1396 patients with normal fasting glucose (NFG) and 1176 with IFG. Results: The patients with IFG lost comparable amounts of weight (10.5 ± 1.3 kg) at three months, as did the subjects with NFG (10.1 ± 1.3 kg). Fasting blood glucose in the IFG group decreased from 108.49 ± 6.4 to 101.8 ± 9.41 mg/dL (p < 0.0001) after three months. There were also significant reductions in triglycerides, and both systolic and diastolic blood pressure in both groups in association with weight loss. Conclusion: Our medically supervised self-pay multidisciplinary weight management program was associated with reduced fasting blood glucose levels in patients with IFG over three months with comparable weight loss to patients with NFG.

scholarly journals Cardiovascular risk after hospitalisation for unexplained syncope and orthostatic hypotension

Heart ◽  
2017 ◽  
Vol 104 (6) ◽  
pp. 487-493 ◽  
Author(s):  
Ekrem Yasa ◽  
Fabrizio Ricci ◽  
Martin Magnusson ◽  
Richard Sutton ◽  
Sabina Gallina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Orthostatic Hypotension ◽  
Cardiovascular Events ◽  
Hospital Admissions ◽  
Cox Regression ◽  
All Cause Mortality ◽  
Unexplained Syncope ◽  
The Impact

ObjectiveTo investigate the relationship of hospital admissions due to unexplained syncope and orthostatic hypotension (OH) with subsequent cardiovascular events and mortality.MethodsWe analysed a population-based prospective cohort of 30 528 middle-aged individuals (age 58±8 years; males, 40%). Adjusted Cox regression models were applied to assess the impact of unexplained syncope/OH hospitalisations on cardiovascular events and mortality, excluding subjects with prevalent cardiovascular disease.ResultsAfter a median follow-up of 15±4 years, 524 (1.7%) and 504 (1.7%) participants were hospitalised for syncope or OH, respectively, yielding 1.2 hospital admissions per 1000 person-years for each diagnosis. Syncope hospitalisations increased with age (HR, per 1 year: 1.07, 95% CI 1.05 to 1.09), higher systolic blood pressure (HR, per 10 mm Hg: 1.06, 95% CI 1.01 to 1.12), antihypertensive treatment (HR: 1.26, 95% CI 1.00 to 1.59), use of diuretics (HR: 1.77, 95% CI 1.31 to 2.38) and prevalent cardiovascular disease (HR: 1.59, 95% CI 1.14 to 2.23), whereas OH hospitalisations increased with age (HR: 1.11, 95% CI 1.08 to 1.12) and prevalent diabetes (HR: 1.82, 95% CI 1.23 to 2.70). After exclusion of 1399 patients with prevalent cardiovascular disease, a total of 473/464 patients were hospitalised for unexplained syncope/OH before any cardiovascular event. Hospitalisation for unexplained syncope predicted coronary events (HR: 1.85, 95% CI 1.49 to 2.30), heart failure (HR: 2.24, 95% CI 1.65 to 3.04), atrial fibrillation (HR: 1.84, 95% CI 1.50 to 2.26), aortic valve stenosis (HR: 2.06, 95% CI 1.28 to 3.32), all-cause mortality (HR: 1.22, 95% CI 1.09 to 1.37) and cardiovascular death (HR: 1.72, 95% CI 1.23 to 2.42). OH-hospitalisation predicted stroke (HR: 1.66, 95% CI 1.24 to 2.23), heart failure (HR: 1.78, 95% CI 1.21 to 2.62), atrial fibrillation (HR: 1.89, 95% CI 1.48 to 2.41) and all-cause mortality (HR: 1.14, 95% CI 1.01 to 1.30).ConclusionsPatients discharged with the diagnosis of unexplained syncope or OH show higher incidence of cardiovascular disease and mortality with only partial overlap between these two conditions.

Prevention of atrial fibrillation – non-modifiable and modifiable risk factors for AF

2020 ◽  
Vol 2 (55) ◽  
pp. 14-19
Author(s):  
Agnieszka Wojdyła-Hordyńska ◽  
Grzegorz Hordyński
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Combined Treatment ◽  
Lifestyle Changes ◽  
Modifiable Risk Factors

Atrial fibrillation is one of the most common arrhythmias, with a significant increase in incidence in recent years. AF is a major cause of stroke, heart failure, sudden cardiac death, and cardiovascular disease. Timely intervention and modification of risk factors increase chance to stop the disease. Aggressive, multilevel prevention tactics are a component of combined treatment, including – in addition to lifestyle changes, anticoagulant therapy, pharmacotherapy and invasive anti-arrhythmic treatment – prevention of cardiovascular diseases, hypertension, ischemia, valvular disease and heart failure.

scholarly journals HYPERTENSIVE PATIENTS;

2013 ◽  
Vol 20 (03) ◽  
pp. 341-347
Author(s):  
SHAHANA ARSHI ◽  
FAKHRA NAHEED ◽  
MAZHAR BADSHAH ◽  
Farah Naz ◽  
Kamran Sardar
Keyword(s):  
Diabetes Mellitus ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Age Groups ◽  
Age Group ◽  
Medical Sciences ◽  
Blood Samples ◽  
Hypertensive Patients ◽  
Glucose Levels ◽  
Secondary Causes

Objective: To see the frequency of diabetes mellitus and impaired fasting glucose levels in hypertensive patients. Design:Descriptive study. Place of Study: OPD / Filter clinic. Pakistan Institute of Medical Sciences. Islamabad. Patients and Methods: Thisstudy was carried out on 116 hypertensive patients during the period from August to September '2008. Out of 116 patients, 64 werefemales and 52 were males with age group between 20 to 70 years. Secondary causes are ruled out on the basis of history and physicalexamination. Blood samples were sent to PIMS laboratory for fasting glucose. Data and results were analyzed in SPSS. Results:According to this study, out of 116 patients, there were18 patients who had diabetes mellitus while 33 had hypertension with impairedfasting glucose tolerance which is statistically significant. The females as compared to males were increased in number who had bothdiabetes mellitus and impaired fasting glucose. According to age diabetes mellitus increased in age groups between 41-50 and 61-70years while impaired fasting glucose were increased in age group between 31-60 yrs. The results indicate that impaired fasting glucose ispresent in significant number of hypertensive patients. Conclusions: Hypertension is associated with diabetes mellitus and impairedfasting glucose.

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