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High prevalence of undiagnosed impaired glucose regulation and diabetes mellitus in patients scheduled for an elective coronary angiography

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Summary

Background

Impaired glucose regulation (IGR) and diabetes mellitus (DM) are amongst the main risk factors for developing coronary heart disease (CHD). The aim of this study was to investigate previously unknown glucose metabolism disorder in patients scheduled for an elective coronary angiography.

Methods

A total of 141 patients scheduled for coronary angiography without signs of acute myocardial ischemia or previous history of a glucose metabolism disorder were prospectively included in the study. An oral glucose tolerance test (OGTT) was performed in each patient.

Results

IGR was diagnosed in 40.4% (95% confidence interval 32.3–49.0) and undetected DM in 22.7% (16.1–30.5) of patients undergoing an elective coronary angiography. Depending on the severity of CHD, the percentage of IGR and DM increased up to 45.3% (34.6–56.5) and 26.7% (17.8–37.4) in the subgroup with the need of percutaneous angioplasty, while the corresponding proportions in the group without CHD were 30.3% (15.6–48.7) and 12.1% (3.4–28.2). The percentage of undiagnosed DM increased with the number of epicardial vessels involved. Using the recommended fasting plasma glucose value of ≥ 126 mg/dl for the diagnosis of DM, we would have missed 71.9% of the patients with undiagnosed DM.

If all patients with a fasting plasma glucose of ≥ 90 mg/dl had been subjected to OGTT, 93.8% of DM would have been identified.

Conclusions

Prevalences of DM and IGR are higher than expected in patients with CHD. An OGTT should be considered for all patients with a fasting plasma glucose ≥ 90 mg/dl undergoing a coronary angiography.

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Authors and Affiliations

  1. Deutsche Diabetes-Klinik und Institut für Biometrie und Epidemiologie, German Diabetes Center, Deutsches Diabetes Zentrum an der Heinrich-Heine-Universität Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany

    M. Lankisch, B. Rose, W. A. Scherbaum & Stephan Martin MD

  2. Herzzentrum Wuppertal, Helios Klinikum, Universität Witten/Herdecke, Arrenbergerstraße 20, 42117, Wuppertal, Germany

    R. Füth, D. Schotes, H. Lapp & H. Gülker

  3. Deutsche Diabetes-Klinik und Institut für Biometrie und Epidemiologie, German Diabetes Center, Deutsches Diabetes Zentrum an der Heinrich-Heine-Universität Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany

    W. Rathmann & B. Haastert

  4. German Diabetes Clinic, German Diabetes Center, Leibniz Institute at the Heinrich-Heine-University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany

    Stephan Martin MD

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  1. M. Lankisch
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Lankisch, M., Füth, R., Schotes, D. et al. High prevalence of undiagnosed impaired glucose regulation and diabetes mellitus in patients scheduled for an elective coronary angiography. Clin Res Cardiol 95, 80–87 (2006). https://doi.org/10.1007/s00392-006-0328-4

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  • DOI: https://doi.org/10.1007/s00392-006-0328-4

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