Post-load Glycemic Levels in Subjects With Angiographically Determined Coronary Artery Stenosis
Author:Boyadzhieva, Mila B.1 , Angelov, Atanas A.2 , Hadzhieva, Elitsa G.1 , Hristozov, Kiril H1 , Georgiev, Svetoslav J.
1 Clinic of Endocrinology, UMHAT “St. Marina”, Medical university, Varna
2 1st Clinic of Cardiology, UMHAT “St. Marina”, Medical university, Varna
3 Clinic of Interventional Cardiology UMHAT “St. Marina”, Medical university, Varna
Introduction: Post-load glycemia (2-h-PG) is a strong predictor for cardiovascular (CV) risk independently of well-known risk factors, including fasting plasma glucose (FPG) and HbA1c. Aim: To search for differences in glycemic indices and especially in 2-h-PG in subjects with or without significant coronary artery stenosis. Materials and Methods: We studied 96 patients (81,3% males) without a history of glucose abnormalities who underwent coronary angiography. Glucose tolerance was defined during OGTT performed 3-10 days after hospital discharge. Coronary stenosis with lumen narrowing 50% was considered significant. Additionally, glycemic indices between normoglycemic coronary artery disease (CAD) patients (n=26) and overall healthy ageand sex adjusted controls without known CV-disease history (n=19) were compared. Results: The levels of 2-h-PG (9,53±0,50; 8,04±0,43 mmol/L; resp. р=0,03) and HbA1c (6,24±0,25; 5,57±0,09% resp.; р=0,01) were significantly higher in patients with significant coronary stenosis compared to patients without significant stenosis. In contrast, FPG did not reach significant differences. Interestingly, 2-h-PG was significantly higher in normoglycemic subjects with established CAD compared to healthy controls (6,41±0,16 vs 5,18±0,28 mmol/L, р=0,0002). In contrast, FPG and HbA1c were similar in the two groups. Conclusion: We found higher 2-h-PG in patients with significant coronary stenosis compared to subjects with non-significant stenosis. On the other hand we found the mean 2-h-PG level in patients with non-significant stenosis (8,04 mmol/L) was in the 2-h-hyperglycemic range. Our observation fits well with the published data regarding association between post-load hyperglycemia and the angiographically determined extent of CAD.
Key words: coronary artery disease, post-load hyperglycemia, OGTT, coronary stenosis