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European Heart Journal 2002 23(16):1267-1275; doi:10.1053/euhj.2001.3113
Copyright © 2002 by the European Society of Cardiology.
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Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose

Q. Qiaoa,f1, K. Pyöräläb, M. Pyöräläb, A. Nissinena, J. Lindströma, R. Tilvisc and J. Tuomilehtoa,d

a Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
b Department of Medicine, University of Kuopio, Kuopio, Finland
c Division of Geriatrics, Department of Medicine, University of Helsinki, Helsinki, Finland
d Department of Public Health, University of Helsinki, Helsinki, Finland

revised November 19, 2001; accepted November 21, 2001

Abstract

Aims To assess the predictive value of fasting and 2-h glucose after a 75g glucose load, with regard to incidence of coronary heart disease and cardiovascular mortality.

Methods and Results 6766 subjects from five Finnish cohorts aged 30–89 years were followed up for 7–10 years. Hazards ratios associated with increasing glucose concentrations were homogeneous over studies. Multivariate Cox regression analyses showed that the hazards ratio for one standard deviation increase in 2-h glucose after logarithmic transformation was 1·17 (95% CI 1·05–1·30) for coronary heart disease incidence and 1·22 (1·09–1·37) for cardiovascular mortality. For fasting glucose, they were 1·05 (0·94–1·17) and 1·13 (1·01–1·25), respectively. Inclusion of 2-h glucose in the model based on fasting glucose significantly improved the prediction (P<0·005 for coronary heart disease incidence and P<0·025 for cardiovascular mortality), whereas fasting glucose did not add significant information to the model initially based on 2-h glucose (P>0·10 for both events).

Conclusion In subjects without a prior history of diabetes the association of 2-h glucose with coronary heart disease incidence and cardiovascular morality is graded and independent. The results of our study indicate that 2-h glucose is superior to fasting glucose in assessing the risk of future cardiovascular disease events.

Key Words: Incidence, mortality, coronary heart disease, diagnostic criteria, diabetes

f1 Correspondence: Dr Qing Qiao, Department of Epidemiology and Health Promotion, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland.

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