High plasma glucose 2 hours after challenge was associated with lower 8-year freedom from transplant coronary artery disease compared to low glucose (56% vs 81%, P<0.01).
Cohort (n=66)
Do metabolic abnormalities of dysmetabolic syndrome predict the development of transplant coronary artery disease in patients without overt diabetes?
Insulin resistance and metabolic abnormalities are significant risk factors for the development of transplant coronary artery disease and reduced survival in non-diabetic transplant recipients.
Absolute Event Rate: 56% vs 81%
p-value: p=<0.01
BACKGROUND: This study examines the hypothesis that metabolic abnormalities of dysmetabolic syndrome are risk factors for transplant coronary artery disease (TxCAD). METHODS AND RESULTS: Sixty-six patients without overt diabetes, 2 to 4 years after surgery, underwent intracoronary ultrasound (ICUS), measurement of plasma glucose and insulin after oral glucose (75 g), and fasting lipid and lipoproteins. TxCAD incidence by angiography or autopsy was prospectively determined during subsequent follow-up (8 years). Coronary artery intimal thickness (IT) and subsequent outcomes were compared in patients stratified as having "high" versus "low" plasma glucose (>8.9 mmol/L) and insulin (>760 pmol/L) 2 hours after glucose challenge; and "abnormal" versus "normal" fasting lipid and lipoprotein concentrations as defined by the National Cholesterol Education PROGRAM: Patients with high glucose or insulin concentrations had greater IT: 0.38+/-0.05 versus 0.22+/-0.02 mm, P0.3 mm than with IT </=0.3 mm. TxCAD incidence was higher in patients with high plasma TG and VLDL and low HDL. CONCLUSIONS: These data suggest that insulin resistance plays a role in TXCAD:
Valantine et al. (2001) conducted a cohort in Transplant coronary artery disease (n=66). High plasma glucose (>8.9 mmol/L) or insulin (>760 pmol/L) 2 hours after glucose challenge vs. Low plasma glucose or insulin was evaluated on Freedom from TxCAD (p=<0.01). High plasma glucose 2 hours after challenge was associated with lower 8-year freedom from transplant coronary artery disease compared to low glucose (56% vs 81%, P<0.01).