Two-hour post-challenge hyperglycemia, but not fasting plasma glucose, associated with severity of coronary artery disease in patients with angina

PLoS One. 2018 Aug 15;13(8):e0202280. doi: 10.1371/journal.pone.0202280. eCollection 2018.

Abstract

Introduction: Postprandial hyperglycemia plays a pivotal role in cardiovascular disease. However, few studies have investigated associations between the severity of coronary artery disease (CAD) and postprandial glucose levels in angina patients without known diabetes before coronary angiography.

Methods: Subjects who were admitted for coronary angiography due to angina and were in stable condition after discharge were recruited. A standard 75-g oral glucose tolerance test (OGTT) was performed at outpatient visits approximately 2-4 weeks after hospital discharge, and fasting and post-challenge blood glucose were measured. Twenty-six volunteers in our hospital staff served as the healthy group. CAD severity was graded using the SYNTAX and Jeopardy scoring systems.

Results: The subjects in the angina group had a higher body mass index, higher fasting glucose, and higher 2-h postprandial glucose than those in the healthy group. The SYNTAX and Jeopardy scores were significantly associated with 2-h postprandial blood glucose (correlation coefficients = 0.164 and 0.187, respectively) but not with fasting glucose. Linear regression analyses revealed that SYNTAX and Jeopardy scores were independently associated with glucose levels at 120 min after OGTT (SYNTAX 95%CI = 0.003-0.103; Jeopardy score 0.002-0.027) but not with fasting glucose.

Conclusion: CAD severity is associated with blood glucose levels after oral glucose challenge in patients without known diabetes before coronary angiography, suggesting that CAD patients should be routinely screened for post-challenge blood glucose.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angina Pectoris / blood*
  • Angina Pectoris / complications*
  • Angina Pectoris / diagnostic imaging
  • Blood Glucose*
  • Body Mass Index
  • Coronary Angiography
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / diagnostic imaging
  • Cross-Sectional Studies
  • Fasting / blood
  • Female
  • Glucose Tolerance Test
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / complications
  • Male
  • Middle Aged
  • Postprandial Period
  • Severity of Illness Index

Substances

  • Blood Glucose

Grants and funding

This work received support from the National Science Council (NSC 101-2314-B-075A-006-MY3) and Taichung Veterans General Hospital, Taichung, Taiwan, ROC (TCVGH-973002D, TCVGH-993001C, VGHUST99-G2-1.