Prediabetes and long-term outcomes in patients with three-vessel coronary artery disease：A large single-center cohort study.

Aims/introduction Whether detection of prediabetes by routinely testing HbA1c and FPG in three-vessel disease (3VD) patients could identify individuals at high risk of future CVD events remains unclear. This study evaluated the relationship between different glycemic status and clinical outcomes in this specific population. Materials and methods This study included 8,891 Chinese patients with 3VD. Patients were categorized according to their glycemic status (Normoglycemia [NG], n=3195; Prediabetes [pre-DM], n=1978; Diabetes mellitus [DM], n=3718). Results The median follow-up time was 7.5 years, during which 1,354 deaths and 2,340 MACCEs occurred. Compared with NG group, patients in Pre-DM and DM group had more comorbidities. After adjusting for confounders, DM group had higher risk of all-cause death (HR 1.36, 95% CI 1.20-1.53; P＜0.001), cardiac death (HR 1.35, 95% CI 1.14-1.61; P＝0.001) and MACCE (HR 1.22, 95% CI 1.11-1.34; P＜0.001) compared with NG group, whereas Pre-DM and NG group had no significant difference. DM group also had higher risk of stroke as compared with NG group (HR 1.22, 95% CI 1.02-1.46; P＝0.031). Conclusion In the context of 3VD, prediabetic patients has comparable long-term outcomes in terms of MACCE, cardiac death, and all-cause death to those with normoglycemia. Routine screening of glycemic metabolism based on HbA1c and FPG might be valuable to identify individuals with DM who are at high risk of future CVD events and individuals with pre-DM who are at high risk of progressing to DM.