title: Long-term clinical outcome in patients with acute coronary syndrome and dysglycaemia.
abstract: BACKGROUND
  Diabetes and impaired glucose tolerance (IGT) are major risk factors for atherosclerosis including coronary artery disease (CAD). The present study's aim was to investigate the importance of glucose tolerance for long-term clinical outcome in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  A total 1062 consecutive patients, 781 men and 281 women, aged 32-80 years, admitted to the coronary care unit at Danderyd University Hospital, Stockholm, for ACS from 2006 to 2008 were included. At discharge, the patients were categorized according to an oral glucose tolerance test (OGTT) as having normal glucose tolerance (NGT), n = 295 (28%); impaired fasting glucose (IFG) and IGT, n = 299 (28%); diabetes discovered by OGTT, n = 156 (15%); or known diabetes at admission, n = 312 (29%). Mortality and reinfarction rates were studied during a mean follow-up time of 4.0 (±0.8) years. Clinical outcome data were obtained from the Swedish Coronary Angiography and Angioplasty Registry and the Swedish National Registry.
  
  
  RESULTS
  There was significantly higher (p < 0.001) mortality within, 30 days, 1 and 3 years in patients with known diabetes as compared to the other groups. During the follow-up, 86 patients (28%) with known diabetes had reinfarction as compared to 36 patients (12%) with NGT and 79 patients (17%) with dysglycaemia (IFG, IGT and diabetes) discovered by OGTT.
  
  
  CONCLUSIONS
  A majority (72% in this study) of patients admitted for ACS have disturbed glucose metabolism, including diabetes, with high prevalence of previously undiagnosed dysglycaemia. Both patients with known diabetes and dysglycaemia discovered by OGTT show a high risk for poor clinical prognosis.
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. jeanette.kuhl@ki.se.|Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 182 88, Stockholm, Sweden. jeanette.kuhl@ki.se.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Kuhl
authors.affiliation: Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. gun.jorneskog@ds.se.
authors.forename: Gun
authors.initials: G
authors.lastname: Jörneskog
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. malin.wemminger@vgregion.se.
authors.forename: Malin
authors.initials: M
authors.lastname: Wemminger
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. mattias.bengtsson@ds.se.
authors.forename: Mattias
authors.initials: M
authors.lastname: Bengtsson
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. pia.lundman@ds.se.
authors.forename: Pia
authors.initials: P
authors.lastname: Lundman
authors.affiliation: Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. drmkalani@googlemail.com.
authors.forename: Majid
authors.initials: M
authors.lastname: Kalani
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003325:Coronary Care Units; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D005951:Glucose Tolerance Test; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D015995:Prevalence; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose