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Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease.
Mayo Clin Proc. 2013 Sep; 88(9):930-41.MC

Abstract

OBJECTIVE

To assess the association between fasting plasma glucose (FPG) and all-cause mortality across the spectrum of coronary artery disease (CAD).

PATIENTS AND METHODS

The study included 18,999 patients during a study period of April 1, 2004, through October 31, 2010. The primary end points were in-hospital and follow-up all-cause mortality. According to the quartiles of FPG levels, patients were categorized into 4 groups: quartile 1, less than 5.1 mmol/L; quartile 2, 5.1 to less than 5.9 mmol/L; quartile 3, 5.9 to less than 7.5 mmol/L; and quartile 4, 7.5 mmol/L or greater. The conversion factor for units of plasma glucose is 1.00 mmol/L equals 18 mg/dL. Presented as mg/dL, the 4 quartile ranges of plasma glucose concentrations used in our data analysis are ≤90.0 mg/dL, 90.1-106.0 mg/dL, 106.1 mg/dL-135.0 mg/dL and ≥135.1 mg/dL. Quartile 1 was recognized as the lower glycemic group, quartiles 2 and 3 as the normoglycemic groups, and quartile 4 as the higher glycemic group.

RESULTS

In patients with acute myocardial infarction, all-cause mortality for the dysglycemic groups was higher than for the normoglycemic groups: in-hospital mortality for quartiles 1, 2, 3, and 4 was 1.0%, 0.9%, 0.2%, and 1.5%, respectively (P=.001); follow-up mortality for quartiles 1, 2, 3, and 4 was 1.7%, 0.9%, 0.3%, and 1.8%, respectively (P<.001). In patients with stable CAD, no significant differences in mortality were found among groups. However, in patients with unstable angina pectoris, the normoglycemic groups had lower follow-up mortality and roughly equal in-hospital mortality compared with the dysglycemic groups. After adjusting for confounding factors, this observation persisted.

CONCLUSION

The association between lower FPG level and mortality differed across the spectrum of CAD. In patients with acute myocardial infarction, there was a U-shaped relationship. In patients with stable CAD or unstable angina pectoris, mildly to moderately decreasing FPG level was associated with neither higher nor lower all-cause mortality.

Authors+Show Affiliations

12th Ward, Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24001485

Citation

Yang, Shi-Wei, et al. "Association of Dysglycemia and All-cause Mortality Across the Spectrum of Coronary Artery Disease." Mayo Clinic Proceedings, vol. 88, no. 9, 2013, pp. 930-41.
Yang SW, Zhou YJ, Tian XF, et al. Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease. Mayo Clin Proc. 2013;88(9):930-41.
Yang, S. W., Zhou, Y. J., Tian, X. F., Pan, G. Z., Liu, Y. Y., Zhang, J., Guo, Z. F., Chen, S. Y., Gao, S. T., Du, J., Jia, D. A., Fang, Z., Hu, B., Han, H. Y., Gao, F., Hu, D. Y., & Xu, Y. Y. (2013). Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease. Mayo Clinic Proceedings, 88(9), 930-41. https://doi.org/10.1016/j.mayocp.2013.05.022
Yang SW, et al. Association of Dysglycemia and All-cause Mortality Across the Spectrum of Coronary Artery Disease. Mayo Clin Proc. 2013;88(9):930-41. PubMed PMID: 24001485.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of dysglycemia and all-cause mortality across the spectrum of coronary artery disease. AU - Yang,Shi-Wei, AU - Zhou,Yu-Jie, AU - Tian,Xiao-Fang, AU - Pan,Guo-Zhong, AU - Liu,Yu-Yang, AU - Zhang,Jian, AU - Guo,Zhen-Feng, AU - Chen,Shu-Yan, AU - Gao,Song-Tao, AU - Du,Jie, AU - Jia,De-An, AU - Fang,Zhe, AU - Hu,Bin, AU - Han,Hong-Ya, AU - Gao,Fei, AU - Hu,Da-Yi, AU - Xu,Yu-Yun, AU - ,, PY - 2013/01/02/received PY - 2013/04/11/revised PY - 2013/05/02/accepted PY - 2013/9/5/entrez PY - 2013/9/5/pubmed PY - 2013/11/14/medline KW - ACC/AHA KW - ACS KW - AMI KW - American College of Cardiology/American Heart Association KW - BHMS KW - Beijing Heart and Metabolism Survey KW - CAD KW - CCS KW - Canadian Cardiovascular Society KW - DIGAMI KW - DM KW - Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction KW - FPG KW - HR KW - LDL-C KW - LVEF KW - PCI KW - SCAD KW - UAP KW - acute coronary syndrome KW - acute myocardial infarction KW - coronary artery disease KW - diabetes mellitus KW - fasting plasma glucose KW - hazard ratio KW - left ventricular ejection fraction KW - low-density lipoprotein cholesterol KW - percutaneous coronary intervention KW - stable coronary artery disease KW - unstable angina pectoris SP - 930 EP - 41 JF - Mayo Clinic proceedings JO - Mayo Clin Proc VL - 88 IS - 9 N2 - OBJECTIVE: To assess the association between fasting plasma glucose (FPG) and all-cause mortality across the spectrum of coronary artery disease (CAD). PATIENTS AND METHODS: The study included 18,999 patients during a study period of April 1, 2004, through October 31, 2010. The primary end points were in-hospital and follow-up all-cause mortality. According to the quartiles of FPG levels, patients were categorized into 4 groups: quartile 1, less than 5.1 mmol/L; quartile 2, 5.1 to less than 5.9 mmol/L; quartile 3, 5.9 to less than 7.5 mmol/L; and quartile 4, 7.5 mmol/L or greater. The conversion factor for units of plasma glucose is 1.00 mmol/L equals 18 mg/dL. Presented as mg/dL, the 4 quartile ranges of plasma glucose concentrations used in our data analysis are ≤90.0 mg/dL, 90.1-106.0 mg/dL, 106.1 mg/dL-135.0 mg/dL and ≥135.1 mg/dL. Quartile 1 was recognized as the lower glycemic group, quartiles 2 and 3 as the normoglycemic groups, and quartile 4 as the higher glycemic group. RESULTS: In patients with acute myocardial infarction, all-cause mortality for the dysglycemic groups was higher than for the normoglycemic groups: in-hospital mortality for quartiles 1, 2, 3, and 4 was 1.0%, 0.9%, 0.2%, and 1.5%, respectively (P=.001); follow-up mortality for quartiles 1, 2, 3, and 4 was 1.7%, 0.9%, 0.3%, and 1.8%, respectively (P<.001). In patients with stable CAD, no significant differences in mortality were found among groups. However, in patients with unstable angina pectoris, the normoglycemic groups had lower follow-up mortality and roughly equal in-hospital mortality compared with the dysglycemic groups. After adjusting for confounding factors, this observation persisted. CONCLUSION: The association between lower FPG level and mortality differed across the spectrum of CAD. In patients with acute myocardial infarction, there was a U-shaped relationship. In patients with stable CAD or unstable angina pectoris, mildly to moderately decreasing FPG level was associated with neither higher nor lower all-cause mortality. SN - 1942-5546 UR - https://www.unboundmedicine.com/medline/citation/24001485/Association_of_dysglycemia_and_all_cause_mortality_across_the_spectrum_of_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(13)00459-X DB - PRIME DP - Unbound Medicine ER -