Cardiovascular risk assessment in prediabetic patients in a hypertensive population: The role of cystatin C

Abstract

Background: The aim of our study was to determine whether prediabetes increases cardiovascular (CV) risk compared to the non-prediabetic patients in our hypertensive population. Once this was achieved, the objective was to identify relevant CV prognostic features among prediabetic individuals.

Methods: We included hypertensive 1652 patients. The primary outcome was a composite of incident CV events: cardiovascular death, stroke, heart failure and myocardial infarction. We performed a Cox proportional hazard regression to assess the CV risk of prediabetic patients compared to non-prediabetic and to produce a survival model in the prediabetic cohort.

Results: The risk of developing a CV event was higher in the prediabetic cohort than in the non-prediabetic cohort, with a hazard ratio (HR) = 1.61, 95% CI 1.01-2.54, p = 0.04. Our Cox proportional hazard model selected age (HR = 1.04, 95% CI 1.02-1.07, p < 0.001) and cystatin C (HR = 2.4, 95% CI 1.26-4.22, p = 0.01) as the most relevant prognostic features in our prediabetic patients.

Conclusions: Prediabetes was associated with an increased risk of CV events, when compared with the non-prediabetic patients. Age and cystatin C were found as significant risk factors for CV events in the prediabetic cohort.

Keywords: Cardiovascular risk assessment; Cystatin C; Essential hypertension; Prediabetes.