Dysglycaemia screening and its prognostic impact in patients with coronary artery disease: experiences from the EUROASPIRE IV and V cohort studies
Authors' conclusion
2hPG appears better than HbA1c in detecting dysglycaemia and predicting its impact on future cardiovascular events in patients with coronary artery disease and should be recommended as the primary screening tool.
Study context
- Population
- Patients aged 18–80 years without diabetes, diagnosed with coronary artery disease 6–36 months (EUROASPIRE IV (EAIV)) or 6–24 months (EAV) before; 79 centres in 24 European countries (EAIV) and 131 centres in 27 European countries (EAV); mean age 63.3 years, 75.9% men7,892 with follow-up
- Participants
- 8,364 patients
- Exposure
- Oral glucose tolerance test (OGTT) vs HbA1c for detecting dysglycaemia and predicting CV events
- Outcome
- Newly detected T2D at baseline and predictors of CV events
- Follow-up
- Median 1.6 years (IQR 1.2-2.0)
Methodological detailsmulticentre, multinational, combined EUROASPIRE IV and V data, Follow-up of CV events by questionnaire at least 1 year after baseline
- Multicentre
- Multinational
- Combined EUROASPIRE IV and V data
- Follow-up of CV events by questionnaire at least 1 year after baseline
Main finding
As reported in the abstract
median follow-up 1.6 years (IQR 1.2-2.0)
- Newly detected T2D, of 8263 patients: OGTT alone vs HbA1c alone
- 1856 (22.5%) vs 346 (4.2%)
- 2hPG ≥9 mmol/L (162 mg/dL) predicting CV events, aHR
- 1.58 (1.27-1.95), p<0.0001 (95% CI)
- HbA1c ≥5.9% (41 mmol/mol) predicting CV events, aHR
- 1.48 (1.19-1.84), p=0.0010
Observational data: associations, not effects.
Further findings
New dysglycaemia (newly detected T2D or impaired glucose tolerance (IGT)) by 2hPG · baseline
- New dysglycaemia according to 2hPG
- 3896 (47.1%)
Multivariable model of CV events
- aHR per 1 unit increase in HbA1c
- 1.13 (0.98-1.30); p=0.11
- aHR per 1 unit increase in Ln[2hPG]
- 1.37 (1.08-1.74); p=0.0042
- Effect of HbA1c on CV events mainly explained by 2hPG
Original publication
Dysglycaemia screening and its prognostic impact in patients with coronary artery disease: experiences from the EUROASPIRE IV and V cohort studies. Lancet Diabetes Endocrinol. Published 23 September 2024. doi:10.
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