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Oral glucose tolerance test predicts increased carotid plaque burden in patients with acute coronary syndrome

Oral glucose tolerance test predicts increased carotid plaque burden in patients with acute coronary syndrome


Titill: Oral glucose tolerance test predicts increased carotid plaque burden in patients with acute coronary syndrome
Höfundur: Bjarnason, Thorarinn Arni   orcid.org/0000-0003-1674-5691
Hafþórsson, Steinar O.
Kristinsdóttir, Linda B.
Óskarsdóttir, Erna S.
Aspelund, Thor   orcid.org/0000-0002-7998-5433
Sigurðsson, Sigurður
Gudnason, Vilmundur   orcid.org/0000-0001-5696-0084
Andersen, Karl
Útgáfa: 2017-08-30
Tungumál: Enska
Umfang: e0183839
Háskóli/Stofnun: Háskóli Íslands
University of Iceland
Svið: Heilbrigðisvísindasvið (HÍ)
School of Health Sciences (UI)
Deild: Læknadeild (HÍ)
Faculty of Medicine (UI)
Birtist í: PLoS ONE;12(8)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0183839
Efnisorð: Glucose metabolism; Carotid arteries; Type 2 diabetes; Coronary heart disease; Sykursýki; Hjartasjúkdómar
URI: https://hdl.handle.net/20.500.11815/459

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Tilvitnun:

Bjarnason TA, Hafthorsson SO, Kristinsdottir LB, Oskarsdottir ES, Aspelund T, Sigurdsson S, et al. (2017) Oral glucose tolerance test predicts increased carotid plaque burden in patients with acute coronary syndrome. PLoS ONE12(8): e0183839. https://doi.org/10.1371/journal.pone.0183839

Útdráttur:

Background Type 2 diabetes and prediabetes are established risk factors for atherosclerosis. The aim of this study was to evaluate the atherosclerotic plaque burden in the carotid arteries of patients with acute coronary syndrome according to their glycemic status. Methods Patients with acute coronary syndrome and no previous history of type 2 diabetes were consecutively included in the study. Glucose metabolism was evaluated with fasting glucose in plasma, HbA1c and a standard two-hour oral glucose tolerance test. Atherosclerotic plaque in the carotid arteries was evaluated with a standardized ultrasound examination where total plaque area was measured and patients classified as having no plaque or a significant plaque formation. Results A total of 245 acute coronary syndrome patients (male 78%, 64 years (SD: 10.9)) were included. The proportion diagnosed with normal glucose metabolism, prediabetes and type 2 diabetes was 28.6%, 64.1% and 7.3%, respectively. A significant atherosclerotic plaque was found in 48.5%, 66.9% and 72.2% of patients with normal glucose metabolism, prediabetes and type 2 diabetes, respectively. An incremental increase in total plaque area was found from normal glucose metabolism to prediabetes (25.5%) and from normal glucose metabolism to type 2 diabetes (35.9%) (p = 0.04). When adjusted for conventional cardiovascular risk factors the OR of having significant atherosclerotic plaque in the carotid arteries was 2.17 (95% CI 1.15–4.15) for patients with newly diagnosed dysglycemia compared to patients with normal glucose metabolism. When additionally adjusted for the 2-hour plasma glucose after glucose loading (2hPG) the OR attenuated to 1.77 (95% CI 0.83–3.84). Conclusion Newly detected dysglycemia is an independent predictor of significant atherosclerotic plaque in the carotid arteries with oral glucose tolerance test as a major determinant of carotid plaque burden in this group of individuals with acute coronary syndrome.

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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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