Association between Prediabetes and Stroke in Hospitalized Geriatric Patients with Atrial Fibrillation: A Contemporary Population-Based Analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The association of prediabetes (pDM) with stroke risk in non-diabetic geriatric patients with AF is unclear. This analysis examined the relationship among pDM, AF, and stroke, highlighting the need for targeted interventions and risk management in this population. Methods: We identified all non-diabetic geriatric admissions with AF using the 2019 National Inpatient Sample and ICD-10-CM coding. Patients were categorized into pDM+ and pDMgroups. The primary outcomes were stroke incidence and sex disparities in stroke risk. Results: Among 218,130 geriatric AF admissions, 3,525(1.6%) had pDM. The pDM+ cohort was younger (median 75 vs 77 years), and had higher rates of hypertension (50.2 vs 43.6%), hyperlipidemia (66.4 vs 53.7%), obesity (30.2 vs 13.6%), and peripheral vascular disease (15.3 vs 9.9%). Adjusting for baseline characteristics, stroke risk was higher in the pDM+ cohort (1.4% vs. 0.8%, OR 2.00, 95% CI 1.06-3.77; p=0.033). In subgroup analyses, males showed a stronger association (OR 5.48, 95% CI 1.43-21.02; p=0.013). Discussion: pDM exists as an underrecognized stroke risk factor in elderly patients with AF. Male patients showed a stronger association between pDM and stroke, warranting additional investigation to understand underlying biological and clinical contributors. Identifying pDM enables earlier detection of vulnerable patients and developing preventive strategies. Incorporating pDM into risk models could improve patient risk assessment and support individualized treatment planning. Conclusion: Geriatric patients hospitalized with AF and concomitant pDM had approximately twofold higher odds of in-hospital stroke, with a male preponderance. These findings support early identification of pDM in AF patients to enable the development of tailored interventions that mitigate stroke risk.
Source: Current Cardiology Reviews
Institutions: Rochester General Hospital, Mercy Catholic Medical Center, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Our Lady of Fatima University, Anne Arundel Medical Center, K. J. Somaiya Hospital & Research Centre, K J Somaiya Medical College, Bukovinian State Medical University, Mediciti Institute of Medical Sciences, HCA Healthcare, Central Michigan University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7154888960
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