Impaired fasting glucose and cardiovascular outcomes in postmenopausal women with coronary artery disease.
BACKGROUND
Type 2 diabetes increases risk for cardiovascular disease. Persons with impaired fasting glucose levels may also have increased risk.


OBJECTIVE
To evaluate the association between glucose status and cardiovascular outcomes and the effect of lowering the fasting glucose level criterion for impaired fasting glucose from a lower limit of 6.1 mmol/L (110 mg/dL) to 5.6 mmol/L (100 mg/dL).


METHODS
Prospective cohort study.


METHODS
20 U.S. clinical centers.


METHODS
2763 postmenopausal women with established coronary heart disease (CHD) who were followed for 6.8 years.


METHODS
Any CHD event (nonfatal myocardial infarction or CHD death), stroke or transient ischemic attack (TIA), congestive heart failure (CHF) hospitalization, and any cardiovascular event.


RESULTS
During follow-up, 583 women had a CHD event, 329 women had a stroke or TIA, and 348 women were hospitalized for CHF. Women with diabetes were at an approximately 75% increased risk for each outcome compared with normoglycemic women. The 218 women with impaired fasting glucose according to the 1997 definition (fasting glucose level, 6.1 to 6.9 mmol/L [110 to 125 mg/dL]) had increased risk for any CHD event (hazard ratio, 1.37 [95% CI, 1.08 to 1.74]), while the 698 women with impaired fasting glucose according to the 2003 definition (fasting glucose level, 5.6 to 6.9 mmol/L [100 to 125 mg/dL]) were not at increased risk (hazard ratio, 1.09 [CI, 0.90 to 1.34]). Most of the women (n = 480) with fasting glucose levels between 5.6 mmol/L (100 mg/dL) and 6.0 mmol/L (109 mg/dL) had no increased risk for CHD (hazard ratio, 0.90 [CI, 0.73 to 1.12]). Women with impaired fasting glucose according to either definition were not at increased risk for stroke or TIA or CHF.


CONCLUSIONS
These findings may not be generalizable to men or women without existing heart disease.


CONCLUSIONS
Among postmenopausal women with coronary artery disease, the 2003 definition for impaired fasting glucose was not associated with increased risk for new CHD, stroke or TIA, or CHF.
Kanaya
Alka M
AM
University of California, San Francisco, San Francisco, California, USA. alkak@itsa.ucsf.edu
Herrington
David
D
Vittinghoff
Eric
E
Lin
Feng
F
Bittner
Vera
V
Cauley
Jane A
JA
Hulley
Stephen
S
Barrett-Connor
Elizabeth
E
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005215:Fasting; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
D001786:Blood Glucose