Key result
Newly diagnosed dysglycemia independently predicted a higher risk of significant atherosclerotic plaque in the carotid arteries among patients with acute coronary syndrome (OR 2.17).
Why the study?
Does newly detected dysglycemia predict increased carotid plaque burden in patients with acute coronary syndrome?
Cohort (n=245)
No
Does newly detected dysglycemia predict increased carotid plaque burden in patients with acute coronary syndrome?
Newly detected dysglycemia, particularly when identified by a 2-hour oral glucose tolerance test, is an independent predictor of increased carotid atherosclerotic plaque burden in patients with acute coronary syndrome.
Answers are grounded in this paper and cite their sources.
Supports dysglycemia screening for carotid plaque risk stratification in ACS; hypothesis-generating and leaves open intervention effects.
BACKGROUND: Type 2 diabetes and prediabetes are established risk factors for atherosclerosis. The aim of this study was to evaluate the atherosclerotic plaque burden in the carotid arteries of patients with acute coronary syndrome according to their glycemic status. METHODS: Patients with acute coronary syndrome and no previous history of type 2 diabetes were consecutively included in the study. Glucose metabolism was evaluated with fasting glucose in plasma, HbA1c and a standard two-hour oral glucose tolerance test. Atherosclerotic plaque in the carotid arteries was evaluated with a standardized ultrasound examination where total plaque area was measured and patients classified as having no plaque or a significant plaque formation. RESULTS: A total of 245 acute coronary syndrome patients (male 78%, 64 years (SD: 10.9)) were included. The proportion diagnosed with normal glucose metabolism, prediabetes and type 2 diabetes was 28.6%, 64.1% and 7.3%, respectively. A significant atherosclerotic plaque was found in 48.5%, 66.9% and 72.2% of patients with normal glucose metabolism, prediabetes and type 2 diabetes, respectively. An incremental increase in total plaque area was found from normal glucose metabolism to prediabetes (25.5%) and from normal glucose metabolism to type 2 diabetes (35.9%) (p = 0.04). When adjusted for conventional cardiovascular risk factors the OR of having significant atherosclerotic plaque in the carotid arteries was 2.17 (95% CI 1.15-4.15) for patients with newly diagnosed dysglycemia compared to patients with normal glucose metabolism. When additionally adjusted for the 2-hour plasma glucose after glucose loading (2hPG) the OR attenuated to 1.77 (95% CI 0.83-3.84). CONCLUSION: Newly detected dysglycemia is an independent predictor of significant atherosclerotic plaque in the carotid arteries with oral glucose tolerance test as a major determinant of carotid plaque burden in this group of individuals with acute coronary syndrome.
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Bjarnason et al. (2017) conducted a cohort in Acute coronary syndrome (n=245). Newly diagnosed dysglycemia vs. Normal glucose metabolism was evaluated on Significant atherosclerotic plaque in the carotid arteries (OR 2.17, 95% CI 1.15-4.15, p=0.02). Newly diagnosed dysglycemia independently predicted a higher risk of significant atherosclerotic plaque in the carotid arteries among patients with acute coronary syndrome (OR 2.17).
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