Abstract 12682: Association Between Acute Hyperglycemia and Coronary Microcirculation
Although acute hyperglycemia, including postprandial or stress hyperglycemia, is a risk factor for coronary artery disease (CAD) and a predictor for prognosis in CAD patients, its association with coronary microcirculation in non-CAD and/or CAD patients remains unclear. This present study was conducted to evaluate the association between acute hyperglycemia induced by oral glucose loading and coronary flow reserve (CFR) evaluated by transthoracic Doppler echocardiography in non-CAD or CAD patients. First, we analyzed changes in CFR (C-CFR) before and 1 hour after oral glucose loading in 52 non-CAD patients without known diabetes mellitus (DM). According to World Health Organization (WHO) criteria, glucose metabolic disorder is divided into 3 groups: normal (N), impaired glucose tolerance (IGT), and DM. CFR decreased after glucose loading in all groups. Although C-CFR in the IGT and DM groups were significantly greater than C-CFR in the normal group, no significant difference between the IGT and DM groups was observed (N: -13±16 %, IGT: -22±7 %* DM: -26±10%**, *p=0.03, **p=0.006 vs. N group, respectively). C-CFR was greater in insulin-resistant patients than in non-insulin resistant patients in the normal group. C-CFR showed a significant negative correlation with HOMA (r=-0.71, p=0.0001) in N group, but not in IGT and DM group. These data indicate that acute hyperglycemia might affect coronary microcirculation not only in IGT patients but also in normal glucose-tolerant patients with insulin resistance. Second, we analyzed the association between C-CFR of the non-culprit coronary artery in 15 myocardial infarction (MI) patients and glucose level on admission (stress hyperglycemia: SH). SH was defined as blood glucose level of greater than 8 mmol/L. C-CFR were markedly greater in MI patients with SH than in those without SH (SH: -19.6±8.0%, non-SH: -4.1±6.7%, p=0.02), independent of various risk factors. CFR impairment induced by acute hyperglycemia might be a predictor of mortality in MI.
Thus, acute hyperglycemia might affect coronary microcirculation even in the early stage of glucose metabolic disorders and influence the prognosis of CAD patients.
- © 2011 by American Heart Association, Inc.