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Exp Clin Endocrinol Diabetes 2021; 129(01): 29-35
DOI: 10.1055/a-0684-9601
Article

The Prognostic Importance of Impaired Fasting Glycemia in Chronic Coronary Heart Disease Patients

David Slezák
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Otto Mayer
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Jan Bruthans
2   Fakultni Thomayerova nemocnice s poliklinikou, Centre for Cardiovascular Prevention , Praha, Czech Republic
,
Jitka Seidlerová
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Martina Rychecká
3   Fakultni Nemocnice Plzen, Dept. of Cardiology, Plzen, Czech Republic
,
Julius Gelžinský
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Markéta Mateřánková
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Petra Karnosová
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
,
Peter Wohlfahrt
2   Fakultni Thomayerova nemocnice s poliklinikou, Centre for Cardiovascular Prevention , Praha, Czech Republic
,
Renata Cífková
2   Fakultni Thomayerova nemocnice s poliklinikou, Centre for Cardiovascular Prevention , Praha, Czech Republic
,
Jan Filipovský
1   Fakultni Nemocnice Plzen, 2nd Dept. of Internal Medicine, Plzen, Czech Republic
› Author Affiliations Funding: The project was supported by the Health Development Agency of the Czech Ministry of Health [project 17-29520 A], Specific Academic Research Project of Charles University [project SVV 260 393] and Charles University Research Fund [PROGRES, project Q39].
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Abstract

Objectives Impaired glucose metabolism represents one the most important cardiovascular risk factors, with steeply raising prevalence in overall population. We aimed to compare mortality risk of impaired fasting glycaemia (IFG) and overt diabetes mellitus (DM) in patients with coronary heart disease (CHD).

Study design prospective cohort study

Methods A total of 1685 patients, 6–24 months after myocardial infarction and/or coronary revascularization at baseline, were followed in a prospective cohort study. Overt DM was defined as fasting glucose ≥ 7 mmol/L and/or use of antidiabetic treatment, while IFG as fasting glucose 5.6–6.99 mmol/L, but no antidiabetic medication. The main outcomes were total and cardiovascular mortality during 5 years of follow-up.

Results During follow-up of 1826 days, 172 patients (10.2%) deceased, and of them 122 (7.2%) from a cardiovascular cause. Both exposures, overt DM (n=623, 37.0% of the whole sample) and IFG (n=436, 25.9%) were associated with an independent increase of 5-year total mortality, compared to normoglycemic subjects [fully adjusted hazard risk ratio (HRR) 1.63 (95%CI: 1.01–2.61)]; p=0.043 and 2.25 (95%CI: 1.45–3.50); p<0.0001, respectively]. In contrast, comparing both glucose disorders one with each other, no significant differences were found for total mortality [HRR 0.82 (0.53–1.28); p=0.33]. Taking 5-years cardiovascular mortality as outcome, similar pattern was observed [HRR 1.96 (95%CI: 1.06–3.63) and 3.84 (95%CI: 2.19–6.73) for overt DM and IFG, respectively, with HRR 0.63 (95%CI: 0.37–1.07) for comparison of both disorders].

Conclusions Impaired fasting glycaemia adversely increases mortality of CHD patients in the same extent as overt DM.

Keywords

pre-diabetes - secondary prevention - total mortality - fatal vascular events - EUROASPIRE


Publication History

Received: 02 May 2018
Received: 28 July 2018

Accepted: 13 August 2018

Article published online:
29 August 2018

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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