title: Low and exacerbated levels of 1,5-anhydroglucitol are associated with cardiovascular events in patients after first-time elective percutaneous coronary intervention.
abstract: Postprandial hyperglycemia plays an important role in the pathogenesis of coronary artery disease and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of postprandial hyperglycemia. However, the impact of 1,5-AG level on cardiovascular events has not been fully investigated.
  
  
  
  We enrolled 240 consecutive patients who had undergone first-time elective percutaneous coronary intervention (PCI) with follow-up angiography within 1 year. We excluded patients with a history of acute coronary syndrome, advanced chronic kidney disease (estimated glomerular filtration rate <30 mL/min/1.73 m2), or uncontrolled diabetes mellitus (HbA1c ≥7.0 %). Fasting blood glucose (FBS), HbA1c, and 1,5-AG levels were measured prior to PCI and at the time of follow-up angiography. Clinical events, including target lesion revascularization, target vessel revascularization, and revascularization of new lesions, were evaluated.
  
  
  
  Subjects were divided into two groups according to clinical outcomes: the Event (+) group (n = 40) and the Event (-) group (n = 200). No significant differences were observed, except for the number of diseased vessels and the prevalence of statin use, in baseline clinical characteristics between the two groups. Serum levels of 1,5-AG at follow-up were significantly lower in the Event (+) group than in the Event (-) group (P = 0.02). A significant reduction in 1,5-AG level from baseline to follow-up was observed in the Event (+) group compared with the Event (-) group (P = 0.04). The association between 1,5-AG levels at follow-up and clinical events remained significant after adjustment for independent variables, including FBS and HbA1c levels (P = 0.04).
  
  
  
  Low and exacerbated levels of 1,5-AG were associated with cardiovascular events in the present study, indicating that postprandial hyperglycemia is an important risk factor for adverse clinical events even in patients with HbA1c < 7.0 %, following first-time elective PCI.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. shimakaz@juntendo.ac.jp.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shimada
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Eiryu
authors.initials: E
authors.lastname: Sai
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shiozawa
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Ouchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Aikawa
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kadoguchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Hamad
authors.initials: H
authors.lastname: Al Shahi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Yoshihara
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Hiki
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D003847:Deoxyglucose / Q000097:blood*; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011237:Predictive Value of Tests; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D003847:Deoxyglucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human; C006584:1,5-anhydroglucitol
keywords: 1,5-Anhydroglucitol; Cardiovascular events; Coronary artery disease; Postprandial hyperglycemia