title: Impaired fasting glucose is associated with increased severity of subclinical coronary artery disease compared to patients with diabetes and normal fasting glucose: evaluation by coronary computed tomographic angiography.
abstract: This study was designed to evaluate the severity of subclinical atherosclerosis in patients with asymptomatic impaired fasting glucose (IFG) compared to those with diabetes mellitus (DM) and normal fasting glucose (NFG), as measured by coronary computed tomographic angiography (CCTA).
  
  
  
  Subjects were divided into three groups: NFG (<100 mg/dL), IFG (100-125 mg/dL) and DM. Coronary artery calcium on non-contrast CT and plaque analysis on CCTA were performed.
  
  
  
  University hospital, single centre.
  
  
  
  216 asymptomatic participants prospectively underwent CCTA for the evaluation of coronary artery disease (CAD).
  
  
  
  Atherosclerotic plaque burden in IFG compared to NFG patients.
  
  
  
  2664 segments were analysed in 120 NFG, 44 IFG and 52 DM participants. The mean calcium scores were 178±395, 259±510 and 414±836 for NFG, IFG and DM, respectively (p=0·037). The mean plaque burdens in the NFG, IFG and DM groups were 0.31±0.45, 0.50±0.69 and 0.68±0.69, respectively (p=0·0007). A greater proportion of patients with DM (19/52, 36.5%) and IFG (13/44, 29.5%) had obstructive CAD compared to those with NFG (16/120, 13.3%) (p=0.0015). The number of segments with severe disease was significantly higher in the DM (60/637, 9.4%) and IFG (42/539, 7.8%) groups compared to that in the NFG group (34/1488, 2.3%) (p=0.0001).
  
  
  
  (1) IFG and DM have significantly higher, but comparable, calcium scores, plaque burden and obstructive CAD compared to NFG in asymptomatic individuals. (2) Pending corroboration by other reports, more intensive efforts may be devoted to the evaluation and treatment of patients with IFG.
authors.affiliation: Department of Cardiology, University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Swaminatha
authors.initials: S
authors.lastname: Gurudevan
authors.affiliation: Department of Cardiology, University of California at Irvine, Irvine, California, USA.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
authors.affiliation: Department of Cardiology, University of California at Irvine, Irvine, California, USA.
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
authors.affiliation: Department of Cardiology, University of California at Irvine, Irvine, California, USA.
authors.forename: Ramni
authors.initials: R
authors.lastname: Khattar
authors.affiliation: Department of Cardiology, University of California at Irvine, Irvine, California, USA.
authors.forename: Farhood
authors.initials: F
authors.lastname: Saremi
authors.affiliation: Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Harvey
authors.initials: H
authors.lastname: Hecht
authors.affiliation: Department of Cardiology, University of California at San Diego, San Diego, California, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: DeMaria
authors.affiliation: Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D000072226:Computed Tomography Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*
chemical_list: D001786:Blood Glucose