Cardio-metabolic Characterisation of Patients with Coronary Heart Disease: Specific Consideration of the 1-h Postprandial Plasma Glucose

Abstract

Cardiovascular events and type 2 diabetes are closely correlated. The clinical impact of this knowledge still appears improvable, since patients frequently develop macrovascular diseases directly after, or even before reaching the routine criteria for diabetes. Consideration of the 1-h plasma glucose in the oral glucose tolerance test (OGTT) might allow detecting a high cardiovascular and/or diabetes risk earlier. We performed OGTTs in patients with unknown diabetes after acute coronary syndromes and compared data of patients reaching either a 1-h plasma glucose<140 mg/dl (n=151) or≥200 mg/dl (n=125). Patients with a low or high 1-h plasma glucose differed in BMI 26.2±3.7 vs. 28.1±3.6 kg/m², waist circumference 95.3±10.7 vs. 101.5±11.7 cm, hypertension 59.6 vs. 73.6%, HDL-cholesterol 46.2±13.5 vs. 43.2±13.9 mg/dl, triglycerides 118.6±57.9 vs. 135.9±59.3 mg/dl, cardiac septum/posterior wall thickness 12±2 vs. 13±2 mm, respectively, left atrium diameter 42±6 vs. 45±7 mm, diabetes 1.3 vs. 36.0%, impaired glucose tolerance 6.6 vs. 35.2%; p<0.05, respectively. In summary, a 1-h OGTT plasma glucose≥200 mg/dl suggests a high cardiovascular risk and might help to identify such patients independently of reaching the definition criteria for manifest diabetes.

Key words

coronary heart disease - metabolic syndrome - insulin resistance

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