Time-saving screening for diabetes in patients with coronary artery disease: a report from EUROASPIRE IV

Gyberg, Viveca; Bacquer, Dirk De; Kotseva, Kornelia; Backer, Guy De; Schnell, Oliver; Tuomilehto, Jaakko; Wood, David; Rydén, Lars

doi:10.1136/bmjopen-2016-013835

Cited by 9 publications

(4 citation statements)

References 31 publications

(20 reference statements)

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“…It would be valuable to validate the time-saving algorithm based on the use of one hour postload glucose from an OGTT in patients at high risk of future cardiovascular events that was suggested based on EUROASPIRE IV patient data. 215 The populations in Studies I and II at risk of future cardiovascular events need better risk factor control. Today, there is a substantial gap between guideline recommendations and daily practice.…”

Section: Future Directionsmentioning

confidence: 99%

The Accuracy of Point-of-Care Equipment for Glucose Measurement in Screening for Dysglycemia in Patients with Coronary Artery Disease

Shahim

Kjellström

Gyberg

et al. 2018

Diabetes Technology & Therapeutics

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Section: Future Directionsmentioning

confidence: 99%

The Accuracy of Point-of-Care Equipment for Glucose Measurement in Screening for Dysglycemia in Patients with Coronary Artery Disease

Shahim

Kjellström

Gyberg

et al. 2018

Diabetes Technology & Therapeutics

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“…At the same in subgroup characterized by lower glycaemia on admission and lower glycated haemoglobin concentration, diabetes was diagnosed the rarest in 4-year observation. Other analysis confirmed that glycated haemoglobin index reliably predicts and enables diagnosis of diabetes among patients with ischemic heart disease, but on the other hand oral glucose tolerance test remains more reliable [19]. Nonetheless examinations indicating deteriorated glucose metabolism obtained during hospital stay should be repeated and patient should remain under strict control.…”

Section: Discussionmentioning

confidence: 98%

Reactive Hyperglycaemia Connected with Low Glycated Haemoglobin – Risk Factor for Cardiovascular Adverse Events

Andres¹,

Rajs²,

Konduracka³

et al. 2021

J Health Care and Research

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Introduction: Concomitance of glucose metabolism disturbances and ischemic heart disease is well known and connected to several times higher incidence of cardiovascular events resulted from atherosclerosis. Aim of this study was to assess impact of reactive hyperglycaemia accompanying chronic and not always optimally treated hyperglycaemia assessed with glycated haemoglobin level on cardiovascular prognosis among patient hospitalised in the course of acute myocardial infarction. Methods: 92 patients diagnosed with ST – segment elevation myocardial infarction (STEMI) qualified to primary percutaneous coronary intervention (pPCI) was included in the study. Study population was divided into subgroups, depending glucose level on admission (reactive hyperglycaemia) and HbA1c concentration: subgroup A (HbA1c <6.5%, Glc<7.8 mmol/l: n = 37; 40,2%), subgroup B (HbA1c <6.5%, Glc ≥.,8 mmol/l: n = 27; 29,3%), subgroup C (HbA1c ≥6.5%, Glc ≥7.8 mmol/l: n = 20; 21,7%) and subgroup D (HbA1c ≥6.5% Glc<7.8 mmol/l: n = 8; 8.7%). Level of myocardium damage was assessed on the basis of concentration of myocardial necrosis enzymes: creatine kinase (CK) and creatine kinase MB fraction (CK-MB) in the 0 and 90th minute and thereafter 8, 16, 24 and 48 hours after hospital admission and also echocardiographic examination. Prognosis in long and short term observation was assessed by major adverse cardiovascular events (MACE) such as death, myocardial infarction, stroke, heart failure requiring hospitalisation and repeated revascularisation and level of glucose metabolism disturbances in intrahospital phase, 4 months and 4 years follow up observation. Results: Results in study population revealed significant change of average value of creatine kinase (p<0,001) and its MB fraction (p<0,001) during first 48 hours of hospitalisation in particular subgroups of patients. Mean values of CK and CK-MB assessed in subsequent hours of hospitalisation (1,5, 8, 16 and 48 hours) were significantly higher in subgroup B (CKp=0,034 and CK-MB p=0,01, respectively). It means that area under curve was significantly higher for subgroup B. In 4 months and 4 year follow up observation, statistically significant difference in frequency of MACE in particular subgroups of patients has been shown (p=0,016; p=0,01). Conclusions: Patients with STEMI undergoing pPCI, who were diagnosed with disturbed carbohydrate metabolism, have inferior clinical outcomes in long term follow up observation. Noticeable difference was observed particularly in subgroup B (HbA1c <6.5%, Glc ≥7.8 mmol/l).

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“…Finding simpler methods e.g. based on a 1 hour post load glucose [ 54 ] to identify individuals at high risk of progression to diabetes and CVD in the need for more targeted prevention strategies remains an important goal.…”

Section: Discussionmentioning

confidence: 99%

Undetected dysglycaemia common in primary care patients treated for hypertension and/or dyslipidaemia: on the need for a screening strategy in clinical practice. A report from EUROASPIRE IV a registry from the EuroObservational Research Programme of the European Society of Cardiology

Shahim

Gyberg

Bacquer

et al. 2018

Cardiovasc Diabetol

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BackgroundDysglycaemia defined as type 2 diabetes (T2DM) and impaired glucose tolerance (IGT), increases the risk of cardiovascular disease (CVD). The negative impact is more apparent in the presence of hypertension and/or dyslipidaemia. Thus, it seems reasonable to screen for dysglycaemia in patients treated for hypertension and/or dyslipidaemia. A simple screening algorithm would enhance the adoption of such strategy in clinical practice.ObjectivesTo test the hypotheses (1) that dysglycaemia is common in patients with hypertension and/or dyslipidaemia and (2) that initial screening with the Finnish Diabetes Risk Score (FINDRISC) will decrease the need for laboratory based tests.Methods2395 patients (age 18–80 years) without (i) a history of CVD or TDM2, (ii) prescribed blood pressure and/or lipid lowering drugs answered the FINDRISC questionnaire and had an oral glucose tolerance test (OGTT) and HbA1c measured.ResultsAccording to the OGTT 934 (39%) had previously undetected dysglycaemia (T2DM 19%, IGT 20%). Of patients, who according to FINDRISC had a low, moderate or slightly elevated risk 20, 34 and 41% and of those in the high and very high-risk category 49 and 71% had IGT or T2DM respectively. The OGTT identified 92% of patients with T2DM, FPG + HbA1c 90%, FPG 80%, 2hPG 29% and HbA1c 22%.Conclusions(1) The prevalence of dysglycaemia was high in patients treated for hypertension and/or dyslipidaemia. (2) Due to the high proportion of dysglycaemia in patients with low to moderate FINDRISC risk scores its initial use did not decrease the need for subsequent glucose tests. (3) FPG was the best test for detecting T2DM. Its isolated use is limited by the inability to disclose IGT. A pragmatic strategy, decreasing the demand for an OGTT, would be to screen all patients with FPG followed by OGTT in patients with IFG.

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Time-saving screening for diabetes in patients with coronary artery disease: a report from EUROASPIRE IV

Cited by 9 publications

References 31 publications

The Accuracy of Point-of-Care Equipment for Glucose Measurement in Screening for Dysglycemia in Patients with Coronary Artery Disease

The Accuracy of Point-of-Care Equipment for Glucose Measurement in Screening for Dysglycemia in Patients with Coronary Artery Disease

Reactive Hyperglycaemia Connected with Low Glycated Haemoglobin – Risk Factor for Cardiovascular Adverse Events

Undetected dysglycaemia common in primary care patients treated for hypertension and/or dyslipidaemia: on the need for a screening strategy in clinical practice. A report from EUROASPIRE IV a registry from the EuroObservational Research Programme of the European Society of Cardiology

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