Prediabetes causes coronary heart disease
Current clinical evidence and Mendelian randomization studies support the conclusion that prediabetes is an independent risk factor causally associated with an increased incidence of coronary heart disease.
The retrieved literature contains robust observational and causal (Mendelian randomization) evidence demonstrating that prediabetes is associated with accelerated atherosclerosis, coronary artery disease severity, and increased coronary heart disease risk.
Ahmed Muhammed, Mohamed Tarek Zaki, Ahmed Shawky Elserafy, Sameh Attia Amin. Correlation between prediabetes and coronary artery disease severity in patients undergoing elective coronary angiography. 2019. https://doi.org/10.1186/s43044-019-0034-y
Paper [2] demonstrates that prediabetes is associated with a high atherosclerotic burden and coronary artery disease complexity comparable to diabetes.
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Zheng Z, Song Y, Cui K, He J, Bian X, Song C, Dong Q, Zhu C, Fu R, Dou K. Prognostic stratification of cardiovascular risk and cardiac remodeling in prediabetes: a multimodal analysis comparing ADA and WHO/IEC diagnostic criteria.. 2026. https://doi.org/10.1186/s12933-026-03123-1
Paper [9] confirms via Mendelian randomization and large-scale prospective analysis that prediabetes is causally associated with increased risks of coronary heart disease and cardiovascular disease.
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