Postchallenge glucose predicts CAD severity

  • Fu CP & al.
  • PLoS One
  • 1 Jan 2018

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Consider oral glucose tolerance test (OGTT) in patients with coronary artery disease (CAD) without known diabetes because the test predicts CAD severity.

Why this matters

  • Postprandial hyperglycemia influences cardiovascular disease.

Study design

  • Standard 75-g OGTTs performed and fasting plasma glucose (FPG) measured 2-4 weeks after hospital discharge in 240 patients admitted for coronary angiography because of angina and compared with 26 healthy control patients.
  • CAD severity was graded using the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) and Jeopardy scoring systems.
  • Funding: National Science Council; Taichung Veterans General Hospital, Taiwan.

Key results

  • SYNTAX score was positively correlated with 2-hour OGTT (r, 0.164; P<.05 and serum creatinine but not with systolic bp high-density lipoprotein triglycerides waist circumference or fpg.>
  • Jeopardy score also positively associated with 2-hour OGTT (r, 0.187; P<.01 but not fpg.>
  • SYNTAX and Jeopardy scores were higher in patients with 2-hour glucose ≥140 mg/dL vs
  • Neither score differed significantly between patients with FPG ≥100 mg/dL vs not significant).
  • Both scores independently associated with 2-hour OGTT after adjustment for confounders.

Limitations

  • Cross-sectional, single-center study.
  • Patients agreeing to postdischarge OGTT may practice better self-care.
  • Controls and patients not matched.
  • All-Asian study population.

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