title: Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome.
abstract: BACKGROUND
  Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS).
  
  
  RESULTS
  We prospectively investigated the clinical impact of glycemic variability (GV), as determined on continuous glucose monitoring system (CGMS), on RP of non-culprit lesions in 88 patients with ACS. RP was deﬁned as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis <50%; development of a new stenosis ≥30% in a previously normal segment; or progression of any stenosis to total occlusion. Patients were classified into 2 groups according to the presence (progressor, n=20) or absence (non-progressor, n=68) of RP. All patients were equipped with a CGMS during the stable phase, and mean amplitude of glycemic excursion (MAGE) was calculated as a marker of GV. Mean MAGE was significantly higher in progressors than in non-progressors (55±19 mg/dl vs. 37±18 mg/dl, P<0.01). On multiple logistic regression analysis, MAGE was an independent predictor of RP (odds ratio, 1.06 per 1 mg/dl; P<0.01).
  
  
  CONCLUSIONS
  MAGE early after the onset of ACS is a predictor of RP of non-culprit lesions.
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kataoka
authors.forename: Masaomi
authors.initials: M
authors.lastname: Gohbara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Iwahashi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sakamaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakachi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Akiyama
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Maejima
authors.forename: Kengo
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000503:physiopathology*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose