Should oral glucose tolerance test be a routine examination after a myocardial infarction?

Henareh, Loghman; Berglund, Margareta; Agewall, Stefan

doi:10.1016/j.ijcard.2003.06.023

Cited by 12 publications

(11 citation statements)

References 17 publications

(16 reference statements)

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“…The de novo diagnosis of carbohydrate intolerance with the OGTT was an important prognostic factor in an unselected sample of patients admitted with a main diagnosis of acute myocardial infarction [12]. These data led to the recent European guidelines [6] highlighting the indication for an OGTT in all patients with cardiovascular disease (Class I indication, level of evidence B), although it was suggested previously [13].…”

Section: Discussionmentioning

confidence: 99%

Poor reproducibility of the oral glucose tolerance test in the diagnosis of diabetes during percutaneous coronary intervention

Jiménez-Navarro

García‐Pinilla

Garrido‐Sánchez

et al. 2010

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Poor reproducibility of the oral glucose tolerance test in the diagnosis of diabetes during percutaneous coronary intervention

Jiménez-Navarro

García‐Pinilla

Garrido‐Sánchez

et al. 2010

International Journal of Cardiology

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“…19 Elevated plasma glucose levels on admission are very common in patients with AMI and can be the first indication of glucose intolerance. 20 However, elevated plasma glucose levels on admission, HbA1c and FPG had a low sensitivity to detect undiagnosed DM.…”

Section: Prevalence Of Glucose Intolerance In Patients With Amimentioning

confidence: 99%

Newly diagnosed glucose intolerance and prognosis after acute myocardial infarction: comparison of post-challenge versus fasting glucose concentrations

Tamita

Katayama

Takagi

et al. 2012

Heart

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BackgroundRecent studies have demonstrated that newly diagnosed glucose intolerance is common among patients with acute myocardial infarction (AMI). The purpose of this study was to assess the long-term clinical cardiovascular outcomes in participants with AMI with abnormal fasting glucose compared with normal fasting glucose and an abnormal oral glucose tolerance test (OGTT) compared with a normal OGTT.MethodsA prospective study was performed in 275 consecutive patients with AMI, 85 of whom had pre-diagnosed diabetes mellitus (DM). Those without DM were divided into two groups based on the 75 g OGTT at the time of discharge. Abnormal glucose tolerance (AGT) was defined as 2 h glucose ≥140 mg/dl; 78 patients had normal glucose tolerance (NGT) and 112 had AGT. The same patients were also reclassified into the normal fasting glucose group (NFG; n=168) or the impaired fasting glucose group (IFG; n=22). The association between the glucometabolic status and long-term major adverse cardiovascular event rates was evaluated.ResultsKaplan–Meier survival curves showed that the AGT group had a worse prognosis than the NGT group and an equivalent prognosis to the DM group (p<0.0005). Cox proportional hazard model analysis showed that the HR of AGT to NGT for major adverse cardiovascular event rates was 2.65 (95% CI 1.37 to 5.15, p=0.004) while the HR of DM to NGT was 3.27 (1.68 to 6.38, p=0.0005). However, Cox HR of IFG to NFG for major adverse cardiovascular event rates was 1.83 (0.86 to 3.87), which was not significant.ConclusionIn patients with AMI, an abnormal OGTT is a better risk factor for future adverse cardiovascular events than impaired fasting blood glucose.

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“…Research has emphasised the benefits of OGTT over FBG in terms of both reliability and sensitivity (Wallender et al 2008). In fact, FBG may miss DS in up to 70% of patients (Jessani et al 2007, Henareh et al 2004. Data suggest that IGT, but not IFG, is a risk factor for cardiovascular diseases, although IFG is associated with an increased risk of progression to IGT (Tominaga et al 1999).…”

Section: Introductionmentioning

confidence: 99%

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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Should oral glucose tolerance test be a routine examination after a myocardial infarction?

Cited by 12 publications

References 17 publications

Poor reproducibility of the oral glucose tolerance test in the diagnosis of diabetes during percutaneous coronary intervention

Poor reproducibility of the oral glucose tolerance test in the diagnosis of diabetes during percutaneous coronary intervention

Newly diagnosed glucose intolerance and prognosis after acute myocardial infarction: comparison of post-challenge versus fasting glucose concentrations

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

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