Frequency of Undiagnosed Diabetes Mellitus in Patients With Acute Coronary Syndrome

Conaway, Darcy Green; O’Keefe, James H.; Reid, Kimberly J.; Spertus, John A.

doi:10.1016/j.amjcard.2005.03.076

Cited by 69 publications

(41 citation statements)

References 5 publications

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“…In a prospective cohort study conducted in the US, a total of 57% of patients with ACS and no previously-recognized diabetes mellitus were shown to have abnormal glucose metabolism using a simple FPG test (Conaway et al 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Coronary artery disease is common in patients with true dysglycaemic syndromes (DS) which includes diabetes mellitus (DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) (Gerstein et al 1996). However, DS are often not diagnosed in patients presenting with acute coronary syndromes (ACS) (Conaway et al 2005). Patients with undiagnosed DS admitted with ACS have a 1-year mortality rate which is similar to that in patients with proven DS (Schiele et al 2006).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with undiagnosed DS admitted with ACS have a 1-year mortality rate which is similar to that in patients with proven DS (Schiele et al 2006). Establishing a diagnosis of DS in patients admitted to hospital with ACS is therefore important because appropriate management has the potential to improve long-term prognosis (Gerstein et al 1996, Conaway et al 2005, Schiele et al 2006, Tenerz et al 2003.…”

Section: Introductionmentioning

confidence: 99%

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Importance of Investigating Mild Hyperglycaemia Using Oral Glucose Tolerance Test in the Setting of Acute Coronary Syndrome: Prospective Investigational Study

Dissanayake¹,

Quek²,

Zeng³

et al. 2013

DIAB

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The aim of this article is to estimate the prevalence of true dysglycaemic syndromes (DS) (includes presence of diabetes mellitus [DM], impaired fasting glucose [IFG] and impaired glucose tolerance [IGT]) in patients with acute coronary syndromes (ACS) and mild fasting hyperglycaemia from an area in New Zealand with the country's highest prevalence of dysglycaemia. Cardiac risk factor data and laboratory findings for 565 consecutive ACS patients were obtained from the hospital database between January 2007 and August 2008. On admission, 175 patients had DS and 168 were normoglycaemic (FBG <5.6 mmol/L). The remaining 222 patients (with previously unknown glycaemic status) had mild fasting hyperglycaemia .9 mmol/L) on admission. This group with mild fasting hyperglycaemia were offered oral glucose tolerance testing (OGTT) >3 months post-discharge to eliminate cases of stress hyperglycaemia. 121 patients underwent OGTT and 41 patients (a third) were found to have true DS (DM in 13, IGT or IFG in 28). Patients who did not undergo OGTT due to a variety of reasons (n=101) had significantly higher body mass index, waist circumference, and higher concentrations of triglycerides and low-density lipoprotein cholesterol, and therefore might be at a higher risk for true DS than those tested. The conclusion is that a third of the OGTT cohort had true DS and therefore even mild hyperglycaemia in this setting should be carefully investigated.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Importance of Investigating Mild Hyperglycaemia Using Oral Glucose Tolerance Test in the Setting of Acute Coronary Syndrome: Prospective Investigational Study

Dissanayake¹,

Quek²,

Zeng³

et al. 2013

DIAB

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“…This clearly is detrimental to the patient because such a diagnosis may represent an opportunity to institute a plan for long-term glycemic control; if initiated early, such an intervention may lead to prevention of complications. More than 50% of patients admitted with acute coronary syndromes have abnormal glucose metabolism (44,45). Recently, the Euro Heart Survey (46) of Ͼ2,000 patients showed that the majority of those with coronary artery disease had abnormal glucose metabolism.…”

Section: Data Derived From Patients With Acute MImentioning

confidence: 99%

“…Recently, the Euro Heart Survey (46) of Ͼ2,000 patients showed that the majority of those with coronary artery disease had abnormal glucose metabolism. Furthermore, almost 70% of patients with their first MI have either impaired glucose tolerance or undiagnosed diabetes (45). Inpatient hyperglycemia may be an indicator of prognosis, and the routine use of an oral glucose tolerance test to identify at-risk coronary artery disease patients may provide the opportunity for preventive care.…”

Section: Data Derived From Patients With Acute MImentioning

confidence: 99%

American College of Endocrinology and American Diabetes Association Consensus Statement on Inpatient Diabetes and Glycemic Control

Diabetes¹

2006

Diabetes Care

212

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Prevalence of unrecognized diabetes, prediabetes and metabolic syndrome in patients undergoing elective percutaneous coronary intervention

Balakrishnan

Berger

Tully

et al. 2015

Diabetes Metabolism Res

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Background Diabetes mellitus (DM) and metabolic syndrome are important targets for secondary prevention in cardiovascular disease. However, the prevalence in patients undergoing elective percutaneous coronary intervention is not well defined. We aimed to analyse the prevalence and characteristics of patients undergoing percutaneous coronary intervention with previously unrecognized prediabetes, diabetes and metabolic syndrome. Methods Data were collected from 740 patients undergoing elective percutaneous coronary intervention between November 2010 and March 2013 at a tertiary referral center. Prevalence of DM and prediabetes was evaluated using Haemoglobin A1c (A1c ≥ 6.5% for DM, A1c 5.7–6.4% for prediabetes). A modified definition was used for metabolic syndrome [three or more of the following criteria: body mass index ≥30 kg/m2; triglycerides ≥ 150 mg/dL; high density lipoprotein <40 mg/dL in men and <50 mg/dL in women; systolic blood pressure ≥ 130 mmHg and/or diastolic ≥ 85 mmHg; and A1c ≥ 5.7% or on therapy]. Results Mean age was 67 years, median body mass index was 28.2 kg/m2 and 39% had known DM. Of those without known DM, 8.3% and 58.5% met A1c criteria for DM and for prediabetes at time of percutaneous coronary intervention. Overall, 54.9% met criteria for metabolic syndrome (69.2% of patients with DM and 45.8% of patients without DM). Conclusion Among patients undergoing elective percutaneous coronary intervention, a substantial number were identified with a new DM, prediabetes, and/or metabolic syndrome. Routine screening for an abnormal glucometabolic state at the time of revascularization may be useful for identifying patients who may benefit from additional targeting of modifiable risk factors.

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Frequency of Undiagnosed Diabetes Mellitus in Patients With Acute Coronary Syndrome

Cited by 69 publications

References 5 publications

Importance of Investigating Mild Hyperglycaemia Using Oral Glucose Tolerance Test in the Setting of Acute Coronary Syndrome: Prospective Investigational Study

Importance of Investigating Mild Hyperglycaemia Using Oral Glucose Tolerance Test in the Setting of Acute Coronary Syndrome: Prospective Investigational Study

American College of Endocrinology and American Diabetes Association Consensus Statement on Inpatient Diabetes and Glycemic Control

Prevalence of unrecognized diabetes, prediabetes and metabolic syndrome in patients undergoing elective percutaneous coronary intervention

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