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NEWLY DIAGNOSED GLUCOMETABOLIC ABNORMALITIES IN ACUTE CORONARY SYNDROME PATIENTS: WHAT HAPPENS AFTER HOSPITAL DISCHARGE?
October 2007, Vol 132, No. 4_MeetingAbstracts Abstract: Poster Presentations | October 2007
NEWLY DIAGNOSED GLUCOMETABOLIC ABNORMALITIES IN ACUTE CORONARY SYNDROME PATIENTS: WHAT HAPPENS AFTER HOSPITAL DISCHARGE? Natalia Antonio, MD*; Carolina Lourenço, MD; Pedro Monteiro, MD; Francisco Gonçalves, MD; Lino Gonçalves, PhD; Mário Freitas, PhD; Luís A Providência, PhD Coimbra University Hospital and Medical School, Coimbra, Portugal Chest. 2007;132(4_MeetingAbstracts):543. doi:10.1378/chest.132.4_MeetingAbstracts.543
Abstract PURPOSE: To evaluate if newly detected Glucometabolic abnormalities (GA) during acute coronary syndromes (ACS) hospitalization remain unchanged after hospital discharge. METHODS: Prospective study of 89 patients consecutively admitted for ACS, with newly recognized GA based on oral glucose tolerance test (OGTT). Patients started on antidiabetic treatment during hospitalisation were excluded. One year after hospital discharge patients were reassessed regarding anthropometric measurements, HbA1c, uric acid and OGTT. RESULTS: In the initial evaluation, 43.8% of patients had diabetes mellitus (DM), 40.4% impaired glucose tolerance (IGT), 9.0% impaired fasting glucose (IFG) and 6.7% both prediabetic states. The second evaluation showed some changes in glucidic profile. In DM group, 69.2% improved its glucidic profile; in IGT group 44.4% improved, 25.0% worsened its glucidic profile and 30.6% remained unchanged; in IFG group 37.5% improved its glucidic profile, 37.5% changed to DM and 25% kept its glucidic profile; in IFG + IGF group 50.0% improved, 33.3% worsened and 16.7% kept its glucidic profile. Spearman correlation coefficients were used to identify factors associated with worsening of basal GA. IFG at baseline, previous coronary artery disease and uric acid were the only variables significantly correlated with glucidic profile worsening (r=0.210, p=0.048; r=0.230, p=0.030; r=0.224, p=0.039, respectively). On multivariate analysis, uric acid was the only independent predictor of progression towards a more severe glucidic profile (p=0.047). CONCLUSION: Newly diagnosed GA are common among ACS patients without previous DM, but they frequently change after hospital discharge. In this population, uric acid was a marker of progression towards a more severe glucidic profile. CLINICAL IMPLICATIONS: GA are an important risk factor for acute ACS. Several trials have shown the usefulness of its systematic evaluation during ACS hospitalisation. However, the evolution of each newly diagnosed glucometabolic abnormality after an ACS is still unknown. DISCLOSURE: Natalia Antonio, No Financial Disclosure Information; No Product/Research Disclosure Information
Wednesday, October 24, 2007 12:30 PM - 2:00 PM
NEWLY DIAGNOSED GLUCOMETABOLIC ABNORMALITIES IN ACUTE CORONARY SYNDROME PATIENTS: WHAT HAPPENS AFTER HOSPITAL DISCHARGE? Natalia Antonio, MD*; Carolina Lourenço, MD; Pedro Monteiro, MD; Francisco Gonçalves, MD; Lino Gonçalves, PhD; Mário Freitas, PhD; Luís A Providência, PhD Coimbra University Hospital and Medical School, Coimbra, Portugal Chest. 2007;132(4_MeetingAbstracts):543. doi:10.1378/chest.132.4_MeetingAbstracts.543
Abstract PURPOSE: To evaluate if newly detected Glucometabolic abnormalities (GA) during acute coronary syndromes (ACS) hospitalization remain unchanged after hospital discharge. METHODS: Prospective study of 89 patients consecutively admitted for ACS, with newly recognized GA based on oral glucose tolerance test (OGTT). Patients started on antidiabetic treatment during hospitalisation were excluded. One year after hospital discharge patients were reassessed regarding anthropometric measurements, HbA1c, uric acid and OGTT. RESULTS: In the initial evaluation, 43.8% of patients had diabetes mellitus (DM), 40.4% impaired glucose tolerance (IGT), 9.0% impaired fasting glucose (IFG) and 6.7% both prediabetic states. The second evaluation showed some changes in glucidic profile. In DM group, 69.2% improved its glucidic profile; in IGT group 44.4% improved, 25.0% worsened its glucidic profile and 30.6% remained unchanged; in IFG group 37.5% improved its glucidic profile, 37.5% changed to DM and 25% kept its glucidic profile; in IFG + IGF group 50.0% improved, 33.3% worsened and 16.7% kept its glucidic profile. Spearman correlation coefficients were used to identify factors associated with worsening of basal GA. IFG at baseline, previous coronary artery disease and uric acid were the only variables significantly correlated with glucidic profile worsening (r=0.210, p=0.048; r=0.230, p=0.030; r=0.224, p=0.039, respectively). On multivariate analysis, uric acid was the only independent predictor of progression towards a more severe glucidic profile (p=0.047). CONCLUSION: Newly diagnosed GA are common among ACS patients without previous DM, but they frequently change after hospital discharge. In this population, uric acid was a marker of progression towards a more severe glucidic profile. CLINICAL IMPLICATIONS: GA are an important risk factor for acute ACS. Several trials have shown the usefulness of its systematic evaluation during ACS hospitalisation. However, the evolution of each newly diagnosed glucometabolic abnormality after an ACS is still unknown. DISCLOSURE: Natalia Antonio, No Financial Disclosure Information; No Product/Research Disclosure Information
Wednesday, October 24, 2007 12:30 PM - 2:00 PM