title: Stress hyperglycaemia in hospitalized patients with coronary artery disease and type 2 diabetes risk.
abstract: BACKGROUND
  
  
  
  OBJECTIVE
  (i) To evaluate glucometabolic status of patients without known diabetes hospitalized due to coronary artery disease (CAD), (ii) to assess markers of systemic inflammation determined during admission and to evaluate their relationship with glucometabolic status and (iii) to analyse usefulness of HbA1c determined during admission in patients with CAD to detect abnormal glucose regulation (AGR).
  
  
  METHODS
  We studied 440 patients with CAD admitted to the cardiology ward. Patients were grouped in four groups during admission according to clinical data, fasting plasma glucose and HbA1c: diabetes, HbA1c > 5·9%, stress hyperglycaemia (SH) and normal. In 199 subjects without known diabetes, an oral glucose tolerance test (OGTT) was performed 3 months after discharge, and they were reclassified according to WHO 1998 criteria. Biochemical and inflammatory markers were measured.
  
  
  RESULTS
  The OGTT showed that 27·4% of subjects without known diabetes at admission had diabetes, 11·2% had impaired fasting glucose + impaired glucose tolerance, 33·5% impaired glucose tolerance, 3·6% impaired fasting glucose, and 24·4% normal glucose metabolism. Odds ratio for having diabetes 3 months after discharge in HbA1c > 5·9% group was 5·91 (P < 0·0001) and in SH group was 1·82 (P = 0·38). The best HbA1c cut-off point to predict AGR was 5·85%. HbA1c levels during admission were highly predictive of having AGR (AUC ROC 0·76 [95% CI 0·67-0·84]).
  
  
  CONCLUSIONS
  We reported a high prevalence of AGR in subjects with CAD. Stress hyperglycaemia in patients with CAD was not associated with an increased risk of diabetes 3 months later. HbA1c in patients hospitalized with CAD was a useful tool to detect AGR.
authors: Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain; CIBERDEM (CB07/08/0019) of the Instituto de Salud Carlos III, Barcelona, Spain.
authors: Natalia
authors: N
authors: Colomo
authors: Francisca
authors: F
authors: Linares
authors: Elehazara
authors: E
authors: Rubio-Martín
authors: María J
authors: MJ
authors: Moreno
authors: Manuel
authors: M
authors: de Mora
authors: Ana M
authors: AM
authors: García
authors: Ana M
authors: AM
authors: González
authors: Gemma
authors: G
authors: Rojo-Martínez
authors: Sergio
authors: S
authors: Valdés
authors: María S
authors: MS
authors: Ruiz de Adana
authors: Gabriel
authors: G
authors: Olveira
authors: Federico
authors: F
authors: Soriguer
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D003925:Diabetic Angiopathies / Q000175:diagnosis*; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000209:etiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000523:psychology*; D008297:Male; D013315:Stress, Psychological / Q000150:complications*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: abnormal glucose regulation; coronary artery disease; stress hyperglycaemia; type 2 diabetes