Long-term clinical outcome in patients with acute coronary syndrome and dysglycaemia

Abstract

BackgroundDiabetes and impaired glucose tolerance (IGT) are major risk factors for atherosclerosis including coronary artery disease (CAD). The present study’s aim was to investigate the importance of glucose tolerance for long-term clinical outcome in patients with acute coronary syndrome (ACS).MethodsA total 1062 consecutive patients, 781 men and 281 women, aged 32–80 years, admitted to the coronary care unit at Danderyd University Hospital, Stockholm, for ACS from 2006 to 2008 were included. At discharge, the patients were categorized according to an oral glucose tolerance test (OGTT) as having normal glucose tolerance (NGT), n = 295 (28 %); impaired fasting glucose (IFG) and IGT, n = 299 (28 %); diabetes discovered by OGTT, n = 156 (15 %); or known diabetes at admission, n = 312 (29 %). Mortality and reinfarction rates were studied during a mean follow-up time of 4.0 (±0.8) years. Clinical outcome data were obtained from the Swedish Coronary Angiography and Angioplasty Registry and the Swedish National Registry.ResultsThere was significantly higher (p < 0.001) mortality within, 30 days, 1 and 3 years in patients with known diabetes as compared to the other groups. During the follow-up, 86 patients (28 %) with known diabetes had reinfarction as compared to 36 patients (12 %) with NGT and 79 patients (17 %) with dysglycaemia (IFG, IGT and diabetes) discovered by OGTT.ConclusionA majority (72 % in this study) of patients admitted for ACS have disturbed glucose metabolism, including diabetes, with high prevalence of previously undiagnosed dysglycaemia. Both patients with known diabetes and dysglycaemia discovered by OGTT show a high risk for poor clinical prognosis.

Relationship between the frequency of nursing activities and adverse outcomes in patients with acute coronary syndrome: A retrospective cohort study

“…In fact, the undesirable physiological or psychological responses of patients during hospitalization can lead to numerous nursing activities (Hinno et al, ; Liu et al, ; Tsai et al, ). Such undesirable problems will eventually worsen the patient's condition, which will affect their long‐term outcome after hospital discharge (Kuhl et al, ). Therefore, in the present study, we applied a new method to measure the actual level of nursing activities, and we eventually found a relationship with long‐term clinical outcomes.…”

Plaque Characteristics in Coronary Artery Disease Patients with Impaired Glucose Tolerance

“…Kuhl et al have reported the percentage of NGT was 28% among 1062 ACS patients [31]. Lenzen et al confirmed 24% of NGT patients among 3940 CAD patients [32].…”

“…Lenzen et al confirmed 24% of NGT patients among 3940 CAD patients [32]. Thus, there have been many patients with potentially unidentified and untreated DM or IGT in this population [31, 32]. The Study To Prevent Non-Insulin-Dependent Diabetes Mellitus (STOP-NIDDM) suggested that the treatment of IGT patients with an α-glucosidase inhibitor was associated with a significant reduction in the risk of cardiovascular disease [5].…”

Study on the Features of Coronary Artery Atheromatous Plaque for Patients with Impaired Glucose Tolerance when Applying Intravascular Ultrasound

“…Eccentric plaque refers to plaque that builds up itself on the wall of the arteries or plaque whose thickest part is more than twice of its thinnest one [9][10][11].…”