The impact of infarct type on the reliability of early oral glucose tolerance testing in patients with myocardial infarction.
BACKGROUND
Previously unknown glucose perturbations are common in patients with myocardial infarction (MI). We evaluated the accuracy of an early oral glucose tolerance test OGTT in relation to the extent of the MI.


METHODS
An OGTT was performed in 134 patients with MI without known diabetes (DM) after 4-5 days (predischarge) and 3 months. The MI was classified as transmural (TMI; n=70) or subendocardial (SEMI; n=102).


RESULTS
Predischarge TMI-patients had normal GT, impaired GT or DM in 31%, 33% and 36%. These proportions were 35%, 39% and 26% after 3 months. The corresponding proportions in SEMI-patients were 35%, 35% and 30% and 35%, 40% and 25%. At admission and the first 2 days fasting glucose was higher in TMI than SEMI-patients.


CONCLUSIONS
The outcome of an early OGTT is valid but the test should not be performed earlier than 4-5 days after the event especially in patients with extensive infarctions.
Cardiology Unit, Department of Medicine, Karolinska Institutet Stockholm, Sweden. Electronic address: camilla.hage@karolinska.se.
Camilla
C
Hage
Cardiology Unit, Department of Medicine, Karolinska Institutet Stockholm, Sweden.
Klas
K
Malmberg
Cardiology Unit, Department of Medicine, Karolinska Institutet Stockholm, Sweden.
Lars
L
Rydén
Cardiology Unit, Department of Medicine, Karolinska Institutet Stockholm, Sweden.
Märit
M
Wallander
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies
D001786:Blood Glucose