Why the study?
Does fasting plasma glucose perform better than HbA1c in screening for diabetes in patients undergoing coronary angiography?
Does fasting plasma glucose perform better than HbA1c in screening for diabetes in patients undergoing coronary angiography?
Fasting plasma glucose outperforms HbA1c for diabetes screening in patients undergoing coronary angiography, and an FPG-based algorithm can significantly reduce the need for OGTTs.
FPG may outperform HbA1c for diabetes screening in angiography patients; leaves open prospective validation before practice change.
OBJECTIVE: The performance of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) was compared in screening for diabetes by an oral glucose tolerance test (OGTT) in patients undergoing coronary angiography (CAG). RESEARCH DESIGN AND METHODS: Patients without known diabetes admitted for CAG were eligible. OGTT and HbA1c were assessed 2-4 weeks after hospital discharge. The performance of HbA1c and FPG was evaluated by using receiver operating characteristic (ROC) analysis. RESULTS: Diabetes was diagnosed in 83 of 400 patients (20.8%). The area under the ROC curve was higher for FPG than for HbA1c (0.81 vs. 0.73, P = 0.032). We proposed a screening algorithm and validated it in another 170 patients. Overall, this algorithm reduced the number of OGTTs by 71.4% (sensitivity 74.4%, specificity 100%). CONCLUSIONS: FPG performed better than HbA1c in screening for diabetes in patients undergoing CAG. A screening algorithm might help to reduce the number of OGTTs.
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Wang et al. (2012) studied this question.
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