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Eur Heart J. 2015 May 14;36(19):1171-7. doi: 10.1093/eurheartj/ehv008. Epub 2015 Feb 9.

Screening for dysglycaemia in patients with coronary artery disease as reflected by fasting glucose, oral glucose tolerance test, and HbA1c: a report from EUROASPIRE IV--a survey from the European Society of Cardiology.

Collaborators (400)

Kotseva K, De Backer G, Amouyel P, Bruthans J, Castro Conde A, Cifkova R, De Bacquer D, De Sutter J, Deckers JW, Dilic M, Dolzhenko M, Erglis A, Ferreira T, Fraz Z, Gaita D, Gielen S, Gotcheva N, Goudevenos I, Gyberg V, Heuschmann P, Laucevicius A, Lehto S, Lovic D, Manini M, Maggioni AP, Miličić D, Moore D, Nicolaides E, Pajak A, Pogosova N, Reiner Ž, Rydén L, Schnell O, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tuomilehto J, Vulic D, Wood D, Wood DA, Kotseva K, Jennings C, Adamska A, Rydén L, Gyberg V, Tuomilehto J, Schnell O, Manini M, Ferreira T, Taylor C, Konte M, Glemot M, De Bacquer D, De Backer G, Sundvall J, Lund L, Leiviskä J, De Bacquer D, De Backer G, De Pauw M, Ghysbrecht C, Vervaet P, Maria Middelares AZ, De Sutter J, Pardaens S, Willems AM, Sint Lucas AZ, Cambier P, Claeys R, Deweerdt N, Nimmegeers J, Vandekerckhove H, Verloove H, Versee L, Vulic D, Djekic D, Malesevic G, Pejicic S, Srdic S, Dilic M, Begic A, Hodzic E, Kulic M, Sabanovic-Bajramovic N, Tahirovic E, Iveljic I, Kovcic J, Kusljugic Z, Nurkic M, Gotcheva N, Baycheva V, Georgiev B, Vladimirov G, Gotchev D, Ivanov S, Miličić D, Samardžić J, Perić B, Sičaja M, Nicolaides E, Eftychiou C, Eteocleous N, Georgiou P, Hadjilouca C, Moutiris JA, Nicolaou R, Papadopoulos K, Patsalou M, Bruthans J, Cífková R, Krajcoviechova A, Wohlfahrt P, Filipovský J, Krizek M, Kviderova Z, Mayer O, Vágovičová P, Vanek J, Seidlerova J, Timoracká K, Adamkova V, Belohoubek J, Galovcova M, Zelenkova V, Lehto S, Kiljander E, Kiljander P, Kylmaoja P, Lehto HR, Olkkonen S, Pennanen J, Herranen M, Amouyel P, Astolfi AL, Balik S, Beauchant S, Dallongeville J, Devoghelaere C, Fievet N, Garboni P, Lemaire B, Marecaux N, Montaye M, Karmann W, Held S, Heuschmann P, Eichstädt K, Deckert L, Fischer D, Gerhardt A, Kircher J, Memmel Y, Nolte K, Schich M, Wahl V, Wagner M, Störk S, Ertl G, Güntner S, Leyh R, Goudevenos I, Kalantzi K, Athanassias D, Goumas G, Krimbas P, Richter D, Sakellariou D, Agrios J, Matthaios I, Papadopoulou E, Toumanidis S, Tsouna-Hatjis E, Boufidou A, Makedou K, Lilis L, Moore D, Broderick G, Fallon N, Storey S, Baronenko I, Dormidontova G, Dulkevica A, Dzerve V, Erglis A, Andrejeva T, Bricina N, Jakovleva J, Jaunromane A, Keive E, Klovane M, Lurina D, Makarova L, Matisone D, Mintale I, Pahomova-Strautina E, Putane L, Stabulniece M, Vasiljevs D, Vevere G, Vilks J, Laucevicius A, Alitoit I, Badariene J, Grabliauskaite I, Jursyte I, Paleviciute E, Petrulioniene Z, Serpytis P, Serpytis R, Solovjova S, Smagriunaite V, Babarskiene R, Ceponiene I, Gustiene O, Karaliute R, Rumbinaite E, Slapikas R, Smalinskas V, Verseckaite R, Pająk A, Brzezicka E, Łysek R, Misiowiec W, Wolfshaut-Wolak R, Nessler J, Podolec P, Mirek-Bryniarska E, Grodecki J, Czarnecka D, Łukaszewska A, Jankowski P, Bogacki P, Gaita D, Avram C, Barzuca E, Gaita L, Jurca-Simina F, Iancu OC, Lazar A, Iurciuc M, Iurciuc S, Mal M, Mancas S, Mihaescu A, Mociar D, Mosteoru S, Pescariu S, Petrescu L, Sasec C, Schiller A, Amarie L, Andronic A, Calin S, Ciobanu A, Cotoban A, Guberna S, Lungeanu L, Mihalcea D, Niculescu N, Rimbas R, Udroiu C, Vinereanu D, Pogosova N, Ausheva A, Boytsov S, Kursakov A, Oganov R, Pozdnyakov Y, Skazin N, Lovic D, Lovic B, Nedeljkovic M, Ostojic M, Djordjevic D, Kostic S, Tasic I, Zdravkovic M, Anđić M, Filipović T, Ilić-Stojanović O, Ješić-Jukić M, Jevsnik N, Lazović M, Radović A, Radović D, Rosić D, Spiroski D, Stevović S, Vidaković T, Vuković-Dejanović V, Fras Z, Jug B, Juhant A, Poljancic A, Poljancic L, Castro Conde A, Dalmau Gonzalez-Gallarza R, Iniesta Manjavacas AM, Stagmo M, Jernhed H, Stensgaard E, Gyberg V, Boström V, Edman Jönsson C, Hage C, Deckers JW, Khatibi S, Yongzhao F, Veerhoek M, Smits PC, Minneboo M, Peters RJ, Scholte Op Reimer W, Snaterse-Zuidam M, Tokgözoğlu L, Asil S, Kaya B, Koçyiğit D, Kozluca V, Tulunay Kaya C, Akyıldız I, Ergene O, Varış E, Akdeniz B, Göldeli Ö, Kozan Ö, Özpelit E, Altay S, Çam N, Eren M, Kayıkçıoğlu M, Kültürsay H, Aytekin V, Burak Çatakoğlu A, Abacı A, Candemir M, Ünlü S, Oğuz A, Barçın C, Yaşar S, Yokuşoğlu M, Aydoğdu S, Temizhan A, Ünal S, Altuğ Çakmak H, Çimci M, Öngen Z, Ateş G, Koylan N, Emet S, Umman B, Bostan C, Sansoy V, Kemal Erol M, Kemal Kalkan A, Kaymaz C, Poçi N, Dolzhenko M, Getman T, Konoplyanik L, Klimenko L, Lobach L, Luchinskaya Y, Lurie L, Lutay M, Mitchenko E, Nemchena O, Nosenko N, Perepelchenko N, Potashev S, Radchenko A, Romanov V, Shumakov V, Simagina T, Sirenko Y, Sychov O, Mohnacheva N, Verezhnikova A, Zharinov O, Lishnevskaya V, Mikropulo I, Prihodko V, Shapovalenko I, Wood D, Adamska A, Evans J, Ioannides K, Jennings C, Kasonta A, Kotseva K, Onyango H, Rapacz A, Wrotniak B, Dubrey S, Barbir M, Connolly S, Dancy M, Collins P, Kaprielian R.

Author information

1
Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm 171 76, Sweden Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden vivecagyberg@gmail.com.
2
Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Department of Public Health, Ghent University, Ghent, Belgium.
3
Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
4
Forschergruppe Diabetes e.V. at the Helmholtz Center, Munich, Germany.
5
Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Disease Risk Unit, National Institute for Health and Welfare, Helsinki, Finland.
6
Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Centre for Vascular Prevention, Danube-University Krems, Krems, Austria Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
7
Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
8
Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm 171 76, Sweden.

Abstract

AIMS:

Three methods are used to identify dysglycaemia: fasting plasma glucose (FPG), 2-h post-load plasma glucose (2hPG) from the oral glucose tolerance test (OGTT), and glycated haemoglobin A1c (HbA1c). The aim was to describe the yield and concordance of FPG, HbA1c, and 2hPG alone, or in combination, to identify dysglycaemia in patients with coronary artery disease.

METHODS AND RESULTS:

In EUROASPIRE IV, a cross-sectional survey of patients aged 18-80 years with coronary artery disease in 24 European countries, 4004 patients with no reported history of diabetes had FPG, 2hPG, and HbA1c measured. All participants were divided into different glycaemic categories according to the ADA and WHO criteria for dysglycaemia. Using all screening tests together, 1158 (29%) had undetected diabetes. Out of them, the proportion identified by FPG was 75%, by 2hPG 40%, by HbA1c 17%, by FPG + HbA1c 81%, and by OGTT (=FPG + 2hPG) 96%. Only 7% were detected by all three methods FPG, 2hPG, and HbA1c. The ADA criteria (FPG + HbA1c) identified 90% of the population as having dysglycaemia compared with 73% with the WHO criteria (OGTT = FPG + 2hPG). Screening according to the ADA criteria for FPG + HbA1c identified 2643 (66%) as having a 'high risk for diabetes', while the WHO criteria for FPG + 2hPG identified 1829 patients (46%).

CONCLUSION:

In patients with established coronary artery disease, the OGTT identifies the largest number of patients with previously undiagnosed diabetes and should be the preferred test when assessing the glycaemic state of such patients.

KEYWORDS:

Coronary artery disease; Diabetes; HbA1c; Impaired fasting glucose; Impaired glucose tolerance; Oral glucose tolerance test

PMID:
25670820
DOI:
10.1093/eurheartj/ehv008
[Indexed for MEDLINE]
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