Prediabetes and atrial fibrillation risk stratification, phenotyping, and possible reversal to normoglycemia

Core Tip

Core Tip: Patients admitted with prediabetes and atrial fibrillation are at high risk of major adverse cardiac or cerebrovascular events independent of confounding variables, as shown by Desai et al. The shared pathophysiology between the three serious and common diseases establish a vicious circle, culminating in high atherogenicity. In another study, Batta and Hatwal raised important points regarding risk stratification, timeline the role of metformin use among patients with prediabetes, and the impact of reversion of prediabetes to normoglycemia on major adverse cardiac or cerebrovascular events. We congratulate Desai et al for their valuable results and Batta and Hatwal for their insights and future directions. We believe and support the above. However, the studies approached inpatients retrospectively. Another important issue that can influence diabetes outcomes is stress hyperglycemia. Here, we give broader insight into proper interventions to reduce the risk of major adverse cardiac or cerebrovascular events in particular glucagon-like peptide-1 agonists, sodium-glucose cotransporters-2 inhibitors, and bariatric surgery.