Oral glucose tolerance test is needed for appropriate classification of glucose regulation in patients with coronary artery disease: a report from the Euro Heart Survey on Diabetes and the Heart

Background: Impaired glucose tolerance (IGT) patients are known to have a higher risk of cardiovascular events and their prognosis is reported to be poor. We, therefore, aimed to compare the complexity and vulnerability of coronary artery disease (CAD) among normal glucose tolerance (NGT), IGT and diabetes mellitus (DM). Methods: 232 patients (66.4 ± 12.6 years, 201 male) who received percutaneous coronary intervention for coronary artery disease were enrolled in the present study. All of the patients except those already given the diagnosis of DM underwent 75g oral glucose tolerance test (OGTT). The study cohorts were divided into 3 groups; DM (n=118), IGT (n=67), and NGT (n=47). IGT was defined as 2 hour post-load plasma glucose ≥140mg/dl during the OGTT. The lesion complexity was expressed as SYNTAX score. The vulnerability of coronary plaque was determined by optical coherence tomography (OCT). Results: Glycated hemoglobin (HbA1c) level was significantly higher in DM group (6.7±1.3%) than IGT (5.8±0.3%, P<0.01) or NGT group (5.6±0.3%, P<0.01). The SYNTAX score in IGT group was equivalent to that in DM group (12.7±8.1 vs.11.8±7.8, P = 0.61), and significantly greater than NGT group (10.2±5.8, P<0.05). OCT identified 137 non-target residual plaques in 101 patients. Out of those plaques, 72 plaques contain lipid core (16, 29, and 27 in NGT, IGT and DM groups, respectively). The size of lipid core expressed as mean angles of lipid arc was significantly greater in IGT and DM groups than NGT group (162.0±58.7°, 171.4±59.3° and 130.9±37.7°, respectively, P<0.05). Fibrous cap covering the lipid core in IGT group was equivalent to that in DM group (0.08±0.03mm vs. 0.09±0.03mm, P=0.10), and significantly thinner than NGT group (0.11±0.05mm, P<0.05). Conclusions: The lesion complexity and plaque vulnerability of IGT patients are not inferior to those of DM patients and significantly greater than NTG patients.

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Postchallenge responses of nitrotyrosine and TNF-alpha during 75-g oral glucose tolerance test are associated with the presence of coronary artery diseases in patients with prediabetes

Cardiovascular Diabetology ◽

10.1186/1475-2840-11-21 ◽

2012 ◽

Vol 11 (1) ◽

pp. 21 ◽

Cited By ~ 16

Author(s):

Chih-Sheng Chu ◽

Kun-Tai Lee ◽

Kai-Hong Cheng ◽

Min-Yi Lee ◽

Hsuan-Fu Kuo ◽

...

Keyword(s):

Coronary Artery ◽

Glucose Tolerance ◽

Oral Glucose Tolerance Test ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Tnf Alpha ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Coronary Artery Diseases

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Predictors of Coronary Plaque Vulnerability in Patients with Stable Coronary Artery Disease

Kardiologiia ◽

10.18087/cardio.2020.10.n1188 ◽

2020 ◽

Vol 60 (10) ◽

pp. 20-26

Author(s):

N. A. Kochergin ◽

A. M. Kochergina ◽

V. I. Ganyukov ◽

O. L. Barbarash

Keyword(s):

Blood Glucose ◽

Coronary Artery ◽

Glucose Tolerance ◽

Glucose Tolerance Test ◽

Coronary Plaque ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Plaque Vulnerability ◽

Vulnerable Plaques

Aim To identify new predictors for vulnerability of atherosclerotic coronary plaques in patients with stable ischemic heart disease (sIHD).Material and methods This prospective, single-center study included 58 patients with sIHD. Unstable plaques were detected with virtual histology intravascular ultrasound of proximal and medium segments of a coronary artery without significant lesions according to coronarography data. Indexes of inflammation, dyslipidemia and carbohydrate metabolism were considered as candidate predictors for coronary plaque vulnerability.Results In 56 coronary arteries, 58 plaques were detected, 12 of which (20.7 %) were unstable. Vulnerable plaques differed morphologically from stable ones by a greater size of the necrotic core (35.1±8.5 % vs. 24.0±13.2 %; р=0.008), calcified nodules (2.0 [1.0; 5.0] % vs. 1.0 [0; 2.0] %; р=0.006), and a lower content of fibrous components (54.9±10.2 % vs. 66.4±15.8 %; р=0.02). In addition, vulnerable plaques more frequently narrowed the arterial lumen by >70 % of the lumen area (33.3 % vs. 2.2 %; р=0.0006). Correlation analysis showed a negative correlation between the level of high-density lipoproteins (HDL) and calcium volume (r= –0.4104; р=0.023); a positive correlation between the blood glucose level as determined by the oral glucose tolerance test and the lipid component (r=0.48198; р=0.033); and a negative correlation between the apolipoprotein A level and the calcium volume (r= –0.4297; р=0.008).Conclusion The study demonstrated a high prevalence of vulnerable plaques in nontarget coronary arteries in patients with sIHD. In this process, dyslipidemia indexes (LDL, apolipoproteins A) correlate with the calcium volume whereas blood glucose, as measured in the oral glucose tolerance test, correlates with the lipid component of coronary plaque.

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