Background/Aims: The coronary angiographic state of patients with abnormal glucose tolerance is unclear.
Methods: We enrolled 1040 consecutive patients undergoing coronary angiography for the evaluation
of coronary artery disease (CAD). An oral glucose tolerance test was performed in
patients without established diabetes.
Results: From our patients, 394 had normal glucose tolerance (NGT), 190 impaired glucose tolerance
(IGT), 90 isolated postprandial diabetes (postprandial glucose ≥200mg/dl), and 366
type 2 diabetes previously established or newly diagnosed on the basis of fasting
glucose (conventional diabetes). Angiographically detectable CAD was more frequent
in patients with IGT, isolated postprandial diabetes, or conventional diabetes when
compared to NGT subjects (87.9%, 95.6%, 89.1% vs. 80.7%; p=0.030, 0.001, 0.043, respectively).
The prevalence of significant coronary stenoses ≥50%, compared to NGT subjects (57.4%),
was similar in IGT patients (59.5%; p=0.628), but significantly higher in patients
with isolated postprandial diabetes (77.8%; p=0.001) or conventional diabetes (68.0%;
p=0.002). Also the number of significant stenoses compared to NGT subjects was similar
in IGT patients, but significantly higher in those with isolated postprandial or conventional
diabetes. As a continuous variable postprandial glucose proved independently associated
with CAD (standardized adjusted odds ratio (OR) 1.624 [95% CI 1.163–2.269]; p=0.004)
and with significant stenoses (OR 1.345 [1.061–1.704]; p=0.014).
Conclusions: Postprandial hyperglycemia is strongly and independently associated with angiographically
characterized CAD. In IGT, non-significant CAD is more frequent than in NGT; the prevalence
and number of significant stenoses increases when postprandial diabetes evolves.
