Abstract 11901: Elevated Blood Glucose Levels and Type 2 Diabetes Are Related to the Risk of Sudden Cardiac Death
Background: The reduction of mortality from sudden cardiac arrest remains a major challenge among patients with impaired glucose levels. It is not well documented whether impaired fasting blood glucose and type 2 diabetes may be risk factors for sudden cardiac death.
Methods: This population study was based on 2641 men 42 to 60 years of age. Elevated fasting blood glucose level was defined according the International Diabetes Federation and type 2 diabetes was defined with either dietary, oral or insulin treatment or high fasting blood glucose (>6.1 mmol/L).
Results: During the 17-year follow-up, there were 167 SCDs. As a continuous variable, one mmol/L (18 mg/dL) increment in blood glucose was related an increase of 10 % in the risk of SCD (adjusted risk 1.10, 95 % CI 1.02 to 1.19, p=0.009). The risk for SCD was 2.44-fold (95 % CI 1.42 to 4.16, p=0.001) among non-diabetic men with slightly elevated fasting glucose (> 5.6 mmol/L, 100 mg/dL) and 2.16-fold (95 % CI 1.28 to 3.64, p=0.0038) in diabetic men, when adjusted for age, body mass index, systolic blood pressure, serum low density lipoprotein cholesterol, smoking, C-reactive protein, energy expenditure of physical activity and a history of myocardial infarction. The Harrell C-index for the total model discrimination was 0.764, while blood glucose provides modest improvement (from 0.758 to 0.764) in the risk prediction when added with other risk factors. The net reclassification index (NRI) was significantly improved (NRI= 0.056, p=0.002) and the integrated discrimination improvement (IDI) was 0.014 (p=0.0001, relative IDI=0.22).
Conclusions: Elevated fasting glucose level in addition to type 2 diabetes is a risk predictor for SCD. There was an improvement in the level of discrimination and the NRI while using impaired fasting blood glucose with conventional risk factors in the prediction of SCD.
- © 2011 by American Heart Association, Inc.