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Although both glucose abnormalities and a history of cardiovascular disease such as coronary artery disease (CAD) or cerebrovascular disease (CVD) are risk factors for cardiovascular disease, few studies have examined the association of changes in glucose tolerance and subsequent CAD and CVD in those with and without a history of cardiovascular disease in the same cohort. Thus, we studied the impact of changes in glucose tolerance status over 2 years on subsequent CAD and CVD in those with and without a history of either. During a 2-year baseline period in which there was worsening, no change, or improvement in glucose tolerance according to a history or no history of CAD/CVD, 363,856 people were classified as having either normoglycemia (NGT), prediabetes (preDM), or diabetes (DM). After baseline, incident CAD and CVD were followed up. The association between changes in glucose tolerance and the incidence of CAD/CVD was analyzed by a multivariate Cox regression model. In the absence of prior CAD/CVD, hazard ratios (HR) for CAD/CVD and CAD were 0.6 to 0.7 for those with ‘DM to preDM’ compared with ‘DM to DM’. In the presence of prior CAD/CVD, the HRs for CAD/CVD, CAD, and CVD were 1.3 to 1.6 in ‘preDM to DM’ compared with ‘preDM to preDM’ (Table). Individualized treatment strategies should consider changes in glucose tolerance status and prior cardiovascular disease. Disclosure C. Shimayama: Employee; Kowa Company, Ltd. K. Fujihara: None. M. Oe: Employee; Kowa Company, Ltd. Y. Uegami: None. H. Takizawa: None. T. Sato: None. H. Suzuki: None. M. Kitazawa: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
Shimayama et al. (2024) studied this question.