Postload glucose spike but not fasting glucose determines prognosis after myocardial infarction in patients without known or newly diagnosed diabetes

Chattopadhyay, Sudipta; George, Anish; John, Joseph; Sathyapalan, Thozhukat

Abstract

Background: The effect of postload glucose spikes (PGS), the difference between 2 hour post-load plasma glucose (2hPLPG) and fasting plasma glucose (FPG), on post–myocardial infarction (post-MI) prognosis in nondiabetic patients is unexplored. Methods: This is a retrospective cohort analysis of 847 nondiabetic post-MI survivors who underwent a predischarge oral glucose tolerance test (median PGS: 2.4 mmol/L). Patients were divided into the unmatched groups 1 and 2 (PGS ≤ and > 2.4 mmol/L) and the propensity score-matched groups 1M and 2M (355 pairs assembled from the overall cohort), and these groups were compared. Major adverse cardiac events (MACE: death and nonfatal reinfarction) were recorded during follow-up (median: 3.4 years). Event-free survival was compared by the Kaplan-Meier method. Multivariate Cox proportional hazards regression determined the predictors of MACE. C-statistics (change in area under the curve, δAUC), continuous net reclassification improvement (NRI>0), and integrated discrimination improvement (IDI) were used to compare models. Results: The number of MACE was higher in groups 2 (27.3% vs 14.2%, P

Citation

Chattopadhyay, S., George, A., John, J., & Sathyapalan, T. (2021). Postload glucose spike but not fasting glucose determines prognosis after myocardial infarction in patients without known or newly diagnosed diabetes. Journal of Diabetes, 13(3), 191-199. https://doi.org/10.1111/1753-0407.13111

• Journal Article Type: Article
• Acceptance Date: Sep 7, 2020
• Online Publication Date: Sep 10, 2020
• Publication Date: Mar 1, 2021
• Deposit Date: May 15, 2021
• Publicly Available Date: Sep 11, 2021
• Journal: Journal of Diabetes
• Print ISSN: 1753-0393
• Electronic ISSN: 1753-0407
• Publisher: Chinese Society of Endocrinology
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 3
• Pages: 191-199
• DOI: https://doi.org/10.1111/1753-0407.13111
• Keywords: Acute coronary syndrome; Diabetes mellitus; Glucose excursion; Glucose spike; Myocardial infarction; Oral glucose tolerance test
• Public URL: https://hull-repository.worktribe.com/output/3711042