Abstract P057: High Risk for the Development of Type 2 Diabetes Mellitus in Patients With Coronary Artery Disease
Introduction and Hypothesis: Diabetes mellitus is a major risk factor for coronary artery disease (CAD); the important question whether conversely CAD confers an increased risk for future diabetes has not been studied so far and is addressed in the present study.
Methods: We prospectively recorded incident diabetes over 7.5 years in 506 consecutive non-diabetic Caucasian patients undergoing coronary angiography for the evaluation of stable CAD, covering 3795 patient years.
Results: During follow-up, 107 patients developed diabetes, i.e. 21.1% of the study population or 2.8% per year. Patients with significant CAD (n = 293) were at a 33% (p = 0.027) increased diabetes risk compared to subjects who did not have significant CAD at the baseline angiography. In search for the factors predisposing to diabetes we identified the metabolic syndrome (MetS) stigmata low HDL cholesterol (OR 1.97 [1.24-3.12]; p = 0.004), high triglycerides (OR = 2.01 [1.26-3.20]; p = 0.004), large waist (OR 2.55 [1.61-4.05]; p <0.001 using the NCEP-ATPIII, 2.10 [1.24-3.54]; p = 0.005 using the IDF cut-off values), and elevated fasting glucose (OR = 3.86 [2.33-6.38]) as well as the clinical entity of the MetS (OR 2.91 [1.83-4.64]; p <0.001) to be powerful predictors of diabetes. Consequently, the relationship between CAD and incident diabetes was attenuated after adjustment for the MetS status. Statin use was not significantly associated with diabetes incidence.
Conclusions: The presence of CAD indicates a strongly increased risk for incident diabetes. Repeated diabetes screening of coronary patients and targeted programs to prevent diabetes in these high-risk patients are warranted.
- © 2013 by American Heart Association, Inc.