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- December 1, 2008 |
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"Postprandial Hyperglycemia and Hypertension Synergistically Predict Multivessel CAD in Patients Undergoing Elective Coronary Angiography"Dr. Thomas C. Wascher (biography)
English - 2005-04-15 - 17 minutes
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Summary :
Background and aims: In patients with coronary artery disease (CAD) undiagnosed disturbances of glucose metabolism mainly represent impaired glucose tolerance and postprandial diabetes (Wascher et al., Atherosclerosis 2004). Hypertension is an additional risk factor that is observed frequently in those patients. We aimed to investigate the impact of hypertension and postprandial hyperglycemia(ppHg) on presence and extent of CAD in patients with angina undergoing elective coronary angiography.
Methods: 231 consecutive patients without known diabetes mellitus fulfilling the criteria for elective coronary angiography were enrolled. All of them underwent an oral glucose tolerance test and ppHg was defined as a 2-hour blood glucose above 120 mg/dl. Hypertension was defined as a blood pressure >130/80 or actual antihypertensive medication. CAD was defined angiographically as a minimum of 50 % stenosis. Multivessel-CAD was defined as stenoses in 3 vessels (CAD3). Frequencies were compared by the Chi-square-test. Relative risk (RR) and 95% confidence intervals (95 % CI) were calculated.
Results: 175 patients had ppHg, 178 patients were found hypertensive. ppHg as associated with a significant risk for CAD (1,575; 1,211-2,135, p<0,001) and CAD3. (2,000; 1,057-4,005, p=0,049). The presence of hypertension was not associated with a higher risk for CAD but a significantly elevated RR for CAD3 was observed (2,169; 1,103-4,538, p=0,036). ppHG and hypertension together resulted in a RR of 1,952 (1,175-3,943, p=0,01) for CAD and of 5,101 (1,098-29,09, p=0,065) for CAD3.
Conclusion: In patients undergoing elective coronary angiography the presence of ppHg and hypertension increase the risk for multivessel CAD in a synergistic manner.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- The relationship between postprandial hyperglycemia, hypertension and CAD in patients with angina undergoing elective coronary angiography.
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