Key result
Among patients undergoing elective angiography for suspected angina, abnormal two-hour glucose was present in 63.2% of those with significant CAD compared to 40.3% without (p=0.004).
Cross-Sectional (n=182)
Absolute Event Rate: 63.2% vs 40.3%
p-value: p=0.004
Unrecognized impaired glucose tolerance and diabetes are highly prevalent in patients undergoing elective coronary angiography, particularly those with significant CAD, and may be missed by fasting plasma glucose testing alone.
Abnormal 2-hour glucose was associated with CAD; hypothesis-generating for OGTT screening and should not yet change practice.
Abnormal glucose metabolism is a known risk factor for coronary artery disease (CAD) and is frequently unrecognised even in patients with acute coronary syndrome. Patients with stable coronary symptoms frequently have multiple risk factors and may have no assessment of glucose regulation. The purpose of this study was to assess the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) in a group of patients with stable symptoms presenting for coronary angiography. A modified oral glucose tolerance test (OGTT) was performed on 182 unselected patients undergoing elective angiography. Patients with known DM were excluded. Demographic data including cardiovascular risk factors, body mass index (BMI), and history of CAD were recorded. In all, 182 patients with a mean age of 62.1 years (±10.7 years) were studied. Indications for angiography were suspected angina. By WHO criteria an abnormal two‐hour glucose was present in 49% of individuals, with 10.4% of these patients having overt DM. An abnormal two‐hour glucose was seen in 63.2% of patients with significant CAD compared with 40.3% with normal or insignificant disease (p=0.004); 48.9% of patients with IGT or DM had normal fasting plasma glucose (FPG). In 78% of patients, BMI was over 25kg/m2. In this high risk population with multiple risk factors for CAD, previously undetected IGT and overt DM are very common. Almost two‐thirds of patients with significant CAD had abnormal glucose regulation. The use of an FPG test alone may miss a significant number of patients with unrecognised glucose intolerance.
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English et al. (2011) conducted a cross-sectional in Suspected angina (n=182). Significant CAD vs. Normal or insignificant CAD was evaluated on Abnormal two-hour glucose (p=0.004). Among patients undergoing elective angiography for suspected angina, abnormal two-hour glucose was present in 63.2% of those with significant CAD compared to 40.3% without (p=0.004).
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