European Heart Journal Advance Access originally published online on November 7, 2006
European Heart Journal 2006 27(24):2969-2974; doi:10.1093/eurheartj/ehl363
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Diabetes known or newly detected, but not impaired glucose regulation, has a negative influence on 1-year outcome in patients with coronary artery disease: a report from the Euro Heart Survey on diabetes and the heart
1 Thoraxcenter, Department of Cardiology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
2 Department of Cardiology, Karolinska University Hospital, Solna, Stockholm, Sweden
Received 24 May 2006; revised 25 September 2006; accepted 19 October 2006; online publish-ahead-of-print 7 November 2006.
* Corresponding author. Tel: +31 10 463 3938. E-mail address: m.simoons{at}erasmusmc.nl
Aims Although diabetes is known to be a major contributor to cardiovascular diseases, as well as an independent predictor for adverse outcomes in patients with coronary artery disease (CAD), information on the prognosis of patients with CAD and newly diagnosed diabetes or impaired glucose regulation (IGR) is scarce. The objective of this study was to explore 1-year outcome in relation to different glucometabolic states of patients participating in the Euro Heart Survey on diabetes and the heart.
Methods and results In 4676 out of 4961 patients, information on the relation between 1-year outcome and glucometabolic state, which was based on oral glucose tolerance test (OGTT) or fasting glucose plasma, was available. A normal glucose metabolism was identified in 947 patients, IGR (impaired fasting glucose or impaired glucose tolerance) in 1116 patients, and diabetes in 1877 patients of whom 1425 were previously diagnosed and 452 newly diagnosed. In total, 736 patients could not be classified, as no OGTT or fasting plasma glucose was performed. Previously recognized and newly detected diabetes was associated with an increased risk of 1-year mortality when compared with patients with normal glucose regulation [hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.5–3.8 and HR 2.0, 95% CI 1.1–3.6, respectively)]. IGR, however, could not be identified as an independent predictor for 1-year mortality (HR 1.1, 95% CI 0.6–1.9).
Conclusion This study confirmed that patients with CAD and known diabetes are at high risk for mortality and cardiovascular events and demonstrated that patients with newly diagnosed diabetes are at intermediate risk for adverse outcomes. IGR, however, could not be identified as an independent predictor for adverse outcomes during the 1-year follow-up period.
Key Words: Diabetes • Impaired glucose regulation • Coronary artery disease • Euro Heart Survey
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