title: Key role of postchallenge hyperglycemia for the presence and extent of coronary atherosclerosis: an angiographic study.
abstract: BACKGROUND
  The associations between impaired glucose tolerance (IGT) and postchallenge diabetes with the presence and extent of angiographically characterized coronary atherosclerosis are unclear.
  
  
  METHODS
  We enrolled 1040 consecutive Caucasian patients undergoing coronary angiography for the evaluation of coronary artery disease (CAD). An oral 75-g glucose tolerance test was performed in patients without previously diagnosed diabetes.
  
  
  RESULTS
  From our patients, 394 had normal glucose tolerance (NGT), 190 impaired glucose tolerance (IGT), 90 isolated postchallenge diabetes (postchallenge glucose >or=200 mg/dl), and 366 type 2 diabetes previously established or newly diagnosed on the basis of fasting glucose (conventional diabetes). Coronary atherosclerosis was more frequent in patients with IGT, isolated postchallenge diabetes, or conventional diabetes when compared to NGT subjects (87.9, 95.6, 89.1 versus 80.7%; p=0.030, 0.001, 0.043, respectively). The prevalence of significant coronary stenoses >or=50%, compared to NGT subjects (57.4%), was similar in IGT patients (59.5%; p=0.628), but significantly higher in patients with isolated postchallenge diabetes (77.8%; p=0.001) or conventional diabetes (68.0%; p=0.002). Also the number of significant stenoses compared to NGT subjects was similar in IGT patients, but significantly higher in those with isolated postchallenge or conventional diabetes. These results were confirmed after multivariate adjustment.
  
  
  CONCLUSIONS
  Abnormal glucose tolerance is strongly and independently associated with angiographically characterized coronary atherosclerosis. In IGT, non-significant coronary atherosclerosis is more frequent than in NGT; the prevalence and number of significant stenoses increases when postchallenge diabetes evolves.
authors.affiliation: Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria.
authors.forename: Christoph H
authors.initials: CH
authors.lastname: Saely
authors.forename: Heinz
authors.initials: H
authors.lastname: Drexel
authors.forename: Harald
authors.initials: H
authors.lastname: Sourij
authors.forename: Stefan
authors.initials: S
authors.lastname: Aczel
authors.forename: Heidrun
authors.initials: H
authors.lastname: Jahnel
authors.forename: Robert
authors.initials: R
authors.lastname: Zweiker
authors.forename: Peter
authors.initials: P
authors.lastname: Langer
authors.forename: Thomas
authors.initials: T
authors.lastname: Marte
authors.forename: Guenter
authors.initials: G
authors.lastname: Hoefle
authors.forename: Werner
authors.initials: W
authors.lastname: Benzer
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wascher
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy*; D023921:Coronary Stenosis / Q000473:pathology; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005947:Glucose