Temporal change in glucose tolerance in non-ST-elevation myocardial infarction

Martin Rutter, U. Srinivas-Shankar, J. D. Somauroo, A. M. Delduca, T. S. Jordan, S. A. Bowles, M. K. Rutter

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    We assessed the prevalence and 3-month change in glucose tolerance status in consecutive non-ST-elevation myocardial infarction (NSTEMI; European Society of Cardiology 2007 definition) patients (N = 49; mean (S.D.) age 65 (11) years) admitted to a coronary care unit, without known diabetes. These patients underwent an oral glucose tolerance test (OGTT) 36-hour (median, IQR: 18-72) after admission and at 3 months. Undiagnosed abnormal glucose tolerance (AGT: impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or new diabetes) was common (61% at admission and 41% at 3 months, p <0.05) and the majority (∼3/4) had IGT. Glucose tolerance status improved in a higher proportion of patients than it worsened (31% vs. 8%, p = 0.04). At 3 months, fasting glucose was unchanged but 2-hour OGTT glucose was lower (mean (S.D.): 8.5 (2.7) mmol/L vs. 7.7 (2.7) mmol/L, p = 0.004). 'Stress hyperglycaemia' could explain higher admission glucose levels and this raises the question about the optimal timing of OGTT in relation to myocardial infarction. Newly diagnosed diabetes was present in ∼10% of patients and this was not reliably detected by fasting plasma glucose. In NSTEMI patients OGTT is the only reliable strategy to identify subjects with IGT and diabetes. © 2008 Elsevier Ireland Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)310-316
    Number of pages6
    JournalDiabetes Research and Clinical Practice
    Issue number3
    Publication statusPublished - Dec 2008


    • Acute coronary syndrome
    • Diabetes
    • Glucose tolerance
    • Non-ST-elevation myocardial infarction
    • Risk factors


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