Department of Cardiology Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Cardiovasc Diabetol. 2012 Aug 8;11:93. doi: 10.1186/1475-2840-11-93.
The incidence of cardiovascular events remains high in patients with myocardial infarction (MI) despite advances in current therapies. New and better methods for identifying patients at high risk of recurrent cardiovascular (CV) events are needed. This study aimed to analyze the predictive value of an oral glucose tolerance test (OGTT) in patients with acute myocardial infarction without known diabetes mellitus (DM).
The prospective cohort study consisted of 123 men and women aged between 31-80 years who had suffered a previous MI 3-12 months before the examinations. The exclusion criteria were known diabetes mellitus. Patients were followed up over 6.03 ± 1.36 years for CV death, recurrent MI, stroke and unstable angina pectoris. A standard OGTT was performed at baseline.
2-h plasma glucose (HR, 1.27, 95% CI, 1.00 to 1.62; P < 0.05) and smoking (HR, 3.56, 95% CI, 1.02 to 12.38; P < 0.05) proved to be independent predictors of CV events in multivariate statistical analysis after adjustments for age, sex, total cholesterol, and other baseline characteristics.
In this study population, with previous MI and without known DM, 2-h PG and smoking were significant predictors of CV death, recurrent MI, stroke and unstable angina pectoris, independent of baseline characteristics and medical treatment.
尽管当前治疗方法取得了进步，但心肌梗死（MI）患者的心血管事件发生率仍然很高。需要新的和更好的方法来识别复发性心血管（CV）事件风险较高的患者。本研究旨在分析口服葡萄糖耐量试验（OGTT）在无已知糖尿病（DM）的急性心肌梗死患者中的预测价值。
这项前瞻性队列研究包括 123 名年龄在 31-80 岁之间的男性和女性，他们在检查前 3-12 个月曾患有先前的 MI。排除标准为已知的糖尿病。对患者进行了 6.03±1.36 年的随访，以观察心血管死亡、复发性 MI、卒中和不稳定型心绞痛。在基线时进行了标准 OGTT。
多变量统计分析显示，2 小时血糖（HR，1.27，95%CI，1.00 至 1.62；P<0.05）和吸烟（HR，3.56，95%CI，1.02 至 12.38；P<0.05）是 CV 事件的独立预测因素，调整了年龄、性别、总胆固醇和其他基线特征后。
在本研究人群中，有先前的 MI 且无已知的 DM，2 小时 PG 和吸烟是 CV 死亡、复发性 MI、卒中和不稳定型心绞痛的重要预测因素，独立于基线特征和药物治疗。
