A slight increase of fasting plasma glucose after 2 years was associated with electrocardiogram changes suggestive of coronary heart disease in normal subjects.
BACKGROUND
Much attention has been focused on the primary prevention of ischemic heart disease (IHD), but the prevalence and prognostic indicators of IHD remain unclear in healthy Japanese subjects.


OBJECTIVE
The purpose of this study was to determine the predictors for the transition of IHD in healthy adult subjects using data from annual medical examinations.


METHODS
We analyzed clinical data on 2710 healthy subjects (1836 men and 874 women aged 26-76 years in 2000) who underwent medical examinations in both 2000 and 2002. Ischemic changes in the electrocardiogram (ECG) suggestive of IHD were defined as the existence of abnormal Q-wave and/or ST-T abnormalities without left ventricular high voltage. We assigned the subjects to two groups: the ischemic heart group (Group I), including subjects with normal ECG findings in 2000, followed by suspicious ischemic changes in the ECGs in 2002; and the normal group (Group N), including subjects with normal ECGs in both 2000 and 2002.


RESULTS
Fifty-nine subjects (2%, 20 women) were assigned to Group I and 2,538 subjects (96%, 810 women) were assigned to Group N. There were significant differences between the two groups in baseline age (Group I vs. Group N: 53 vs. 47 years, p < 0.001), body mass index (24 vs. 23 kg/m2, p = 0.036), systolic blood pressure (132 vs. 122 mmHg, p < 0.001), diastolic blood pressure (83 vs. 76 mmHg, p < 0.001), and fasting plasma glucose (109 vs. 96 mg/dl, p < 0.001). Fasting plasma glucose significantly increased in Group I (from 109 to 113 mg/dl, p = 0.034) during the study. Multivariate analysis showed significant differences in age (p < 0.001) and fasting plasma glucose (p = 0.0053).


CONCLUSIONS
Advanced age and relatively elevated fasting plasma glucose appeared to be significant predictors of ECG findings suggestive of IHD in normal subjects in the short period of 2 years.
Suzuki
Shoji
S
Division of Internal Medicine, Tsukuba Memorial Hospital, Japan. suzuki_shoji@tsukuba-kinen.or.jp
Iida
Keiji
K
Murakoshi
Nobuyuki
N
Niho
Bunpei
B
Yoshida
Tadashi
T
Enomoto
Tsuyoshi
T
Koseki
Susumu
S
Watanabe
Shigeyuki
S
Yamaguchi
Iwao
I
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis
D001786:Blood Glucose