Prevalence of diabetes in patients with nonacute CAD
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- Sasso, F.C., Furbatto, F., Carbonara, O. et al. Acta Diabetol (2011) 48: 247. doi:10.1007/s00592-011-0263-3
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Actually, the prevalence of diabetes in CAD patients is not clearly estimated because diagnosis is generally based on not exhaustive criteria, such as history of diabetes or hyperglycemia during acute events.
We aimed to evaluate the true prevalence of diabetes in nonacute patients affected by CAD, as assessed by coronary angiography.
Six hundred and seventy nine patients admitted from November 2008 to November 2009 in the Cardiology Ward of University of Naples to perform angiography for suspect CAD were assessed for eligibility.
The number of vessels with obstructive plaque (≥50% lumen narrowing) was higher in diabetic than in nondiabetic group (1.12 ± 1.13 vs. 1.68 ± 1.33; P < 0.01), confirming that it is clinically crucial to make diagnosis of diabetes. Within diabetic subjects, the number of stenosed vessels was similar in all quintiles of HbA1c, thus vessel involvement appears independent of glycemic control. No significant difference was observed in the number of stenosed vessels between prediabetes group and normoglycemic group. Quantitative coronary angiography did not show a significant difference between diabetic and nondiabetic group (prevalence of type B2-C lesions, respectively, 85.6% vs. 82.6%, P = ns).
In our study, OGTT permitted to identify an overall prevalence of diabetes in CAD subjects 2.5-fold higher than the sole history and/or fasting glucose values did. Therefore, we suggest to perform OGTT in all the patients affected by CHD to identify most unknown diabetes and improve CV outcome by adequate therapy .