期刊
JOURNAL OF CARDIAC FAILURE
卷 20, 期 8, 页码 584-592出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2014.05.011
关键词
Fasting plasma glucose; diabetes; risk factor; heart failure; meta-analysis
资金
- Academy of Finland, Helsinki, Finland
- City of Kuopio, Kuopio, Finland
- Finnish Medical Foundation, Helsinki, Finland
- Finnish Cultural Foundation, Helsinki, Finland
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.
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