Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China.
Diab Vasc Dis Res. 2020 Jan-Feb;17(1):1479164119896978. doi: 10.1177/1479164119896978.
To investigate the relationship of 1-h postload plasma glucose during the oral glucose tolerance test with the severity of coronary artery lesions and risk of 1-year re-admission in coronary heart disease patients with normal glucose tolerance.
A total of 266 consecutive coronary heart disease patients who underwent coronary angiography and had normal glucose tolerance confirmed by oral glucose tolerance test during hospitalization were prospectively enrolled and followed in two groups according to the 1-h postload plasma glucose cut-off point (1-h postload plasma glucose <155 mg/dL, = 149 and 1-h postload plasma glucose ⩾155 mg/dL, = 117). Angiographic severity was assessed by number of diseased vessels, lesion morphology and Gensini score. The risk of 1-year re-admission with adverse cardiovascular events after discharge was analysed.
Subjects with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of multivessel disease and complex lesions, Gensini score and risk of 1-year re-admission than subjects with a 1-h postload plasma glucose <155 mg/dL (all < 0.05). In the stepwise multivariate regression analysis, 1-h postload plasma glucose was the major determinant of the Gensini score. Subgroup analyses by sex showed that men with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of complex lesions and risk of 1-year re-admission than men with a 1-h postload plasma glucose <155 mg/dL (all < 0.05).
Coronary heart disease patients with normal glucose tolerance and elevated 1-h postload plasma glucose levels had a greater severity of coronary artery lesions and an increased risk of re-admission with adverse cardiovascular events, particularly in men.
探讨口服葡萄糖耐量试验 1 小时后血浆葡萄糖与冠状动脉病变严重程度及冠心病糖耐量正常患者 1 年再入院风险的关系。
连续前瞻性纳入 266 例因冠心病住院且经口服葡萄糖耐量试验证实糖耐量正常的患者，根据 1 小时后血浆葡萄糖切点（1 小时后血浆葡萄糖<155mg/dL，=149 和 1 小时后血浆葡萄糖 ⩾155mg/dL，=117）将患者分为两组。通过病变血管数、病变形态和 Gensini 评分评估冠状动脉病变严重程度。分析出院后不良心血管事件再入院的风险。
1 小时后血浆葡萄糖 ⩾155mg/dL 的患者多支血管病变和复杂病变的发生率、Gensini 评分和 1 年再入院风险均高于 1 小时后血浆葡萄糖 <155mg/dL 的患者（均 < 0.05）。在逐步多元回归分析中，1 小时后血浆葡萄糖是 Gensini 评分的主要决定因素。按性别亚组分析显示，1 小时后血浆葡萄糖 ⩾155mg/dL 的男性复杂病变和 1 年再入院风险均高于 1 小时后血浆葡萄糖 <155mg/dL 的男性（均 < 0.05）。
糖耐量正常但 1 小时后血浆葡萄糖升高的冠心病患者冠状动脉病变更严重，不良心血管事件再入院风险增加，尤其是男性。
