Prediabetes is Associated with Worse Long-Term Outcomes in Young Patients with Acute Coronary Syndrome

Rongdi Xu,1,2 Cheng Wang,1,2 Jiachun Lang,1,2 Jikun Wu,1,2 Yuecheng Hu,2 Tong Wang,1,2 Jingxia Zhang,2 Hongliang Cong,1– 3 Le Wang2,3 1Clinical School of Thoracic, Tianjin Medical University, Tianjin, People’s Republic of China; 2Department of Cardiology, Tianjin Chest Hospital, Tianjin, People’s Republic of China; 3Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology Bureau, Tianjin Chest Hospital, Tianjin, People’s Republic of ChinaCorrespondence: Hongliang Cong; Le Wang, Department of Cardiology, Tianjin Chest Hospital, 261 Tai’erzhuang Road, Jinnan District, Tianjin, 300222, People’s Republic of China, Tel +86-22-88185003, Email hongliangcong@126.com; 2003615300@163.comPurpose: The incidence of prediabetes mellitus (pre-DM) is increasing among young individuals. Whether pre-DM can predict adverse cardiovascular events in acute coronary syndrome (ACS) patients remains controversial. This study aimed to investigate the impact of pre-DM on the long-term clinical outcomes of patients aged≤ 45 years with new-onset ACS.Patients and methods: A total of 1113 patients with new-onset ACS (aged≤ 45 years) who underwent percutaneous coronary intervention (PCI) were enrolled in this study. Patients were divided into three groups according to their glycemic status or history: normal glucose metabolism (NGM), prediabetes (pre-DM), and diabetes mellitus (DM). The primary endpoint was defined as a composite of major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction (MI), stroke, or unplanned repeat revascularization. Multivariate Cox regression analysis was performed to explore the association between abnormal glycemic status and MACE.Results: The prevalence of NGM, pre-DM, and DM were 45.9% (n=511), 27.0% (n=301), and 27.0% (n=301), respectively. During a median follow-up of 65 months, MACE occurred in 23.5% (n=120) of NGM, 29.2% (n=88) of pre-DM, and 34.6% (n=104) of D