Value of oral glucose tolerance test in the acute phase of myocardial infarction

Cardiovascular Diabetology

Original Investigation

Zofia Grabczewska¹  Przemyslaw Magielski¹  Marek Kozinski¹  Jacek Kubica¹  Joanna Gierach¹  Tomasz Fabiszak¹  Iwona Swiatkiewicz¹  Adam Sukiennik¹  Marek Bronisz²  Agata Bronisz³  Roman Junik³  Aldona Kubica⁴  Anna Sinkiewicz⁵ 

[1] Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland;Department of Cardiology, PS ZOZ Regional Hospital, Inowrocław, Poland;Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland;Department of Health Promotion, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland;Department of Phoniatrics and Voice Rehabilitation, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland;

关键词: Glucose Metabolism;    Acute Myocardial Infarction;    Acute Myocardial Infarction;    Oral Glucose Tolerance Test;    Impaired Glucose Tolerance;   

DOI  :  10.1186/1475-2840-10-21

 received in 2011-01-11, accepted in 2011-03-11,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAlthough European guidelines advise oral glucose tolerance test (OGTT) in patients with acute myocardial infarction (AMI) before or shortly after hospital discharge, data supporting this recommendation are inconclusive. We aimed to analyze whether disturbances in glucose metabolism diagnosed before hospital discharge in AMI patients represents a latent pre-existing condition or rather temporary finding. Additionally, we planned to investigate the value of pre-selected glycemic control parameters as predictors of long-term glucometabolic state.MethodsWe assessed admission glycemia, glycated hemoglobin, mean blood glucose concentration on days 1 and 2 in 200 patients with a first AMI but without overt disturbances of glucose metabolism. We also performed OGTT at discharge and 3 months after discharge.ResultsThe prevalence of disturbances in glucose metabolism (as assessed by OGTT) at 3 months was significantly lower than at discharge (29% vs. 48%, p = 0.0001). Disturbances in glucose metabolism were not confirmed in 63% of patients with impaired glucose tolerance and in 36% of patients with diabetes mellitus diagnosed during the acute phase of AMI. Age >77 years, glucose ≥12.06 mmol/l at 120 minutes during OGTT before discharge and mean blood glucose level on day 2 >7.5 mmol/l were identified as independent predictors of disturbances in glucose metabolism at the 3-month follow-up.ConclusionsDisturbances in glucose metabolism observed in patients with a first AMI are predominantly transient. Elderly age, high plasma glucose concentration at 120 minutes during OGTT at discharge and elevated mean blood glucose level on day 2 were associated with sustained disturbances in glucose metabolism.

【 授权许可】

Unknown   
© Bronisz et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.