Prediabetes Signals CAD Risk

Individuals with impaired fasting glucose levels – often called prediabetics – appear to have similar cardiovascular risk factors as patients with diabetes, researchers reported here.

In the study, about 36% of patients with impaired fasting glucose had coronary artery disease compared with 42% of patients with diabetes and 21% of patients with normal blood glucose said Harith Al-Shuwaykh, MD, a resident in internal medicine at Crittenton Hospital Medical Center, Wayne State University, Detroit.

Those findings, which were based on a review of 86 patients who underwent elective percutaneous coronary intervention, were presented at the annual meeting of the American Association of Clinical Endocrinologists.

Likewise 37% of patients with impaired fasting glucose had hyperlipidemia compared with 38% of patients with diabetes and 24% of patients with normal blood glucose.

Al-Shuwaykh told MedPage Today the results indicate that early intervention among the prediabetics may be warranted.

"It is recommended to identify and treat impaired fasting glucose patients early since impaired fasting glucose patients' distribution in coronary artery disease is comparable to diabetes mellitus," he said at his poster presentation. He noted that both impaired fasting glucose patients and diabetes patients had nearly double the distribution of hypertension and high cholesterol when compared with normal fasting glucose patients.

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Note that this in this small, single-center study of patients who underwent elective PCI, diabetes or impaired fasting glucose was associated with a higher risk of evident coronary artery disease. Be aware that by only including patients undergoing elective PCI, this study is not generalizable to the broader population of patients with impaired fasting glucose.

He said his results also suggest a need to screen patients with a family history of coronary artery diseases for impaired fasting glucose and diabetes since 40% of the patients with impaired fasting glucose has a family history of heart disease and 33% of those with diabetes had a family history of heart disease.

"In our study we tried to find the impact and contribution of impaired fasting glucose as a risk factor for coronary artery disease in a population of patients who already have coronary disease," Al-Shuwaykh explained. "We found that a large percentage of these people do have diabetes but the people with impaired glucose levels have similar risk profiles."

The chart review revealed that 19 of the individuals had normal fasting glucose levels, that is fasting blood glues below 100 mg/dL; 30 patients had impaired fasting blood glucose levels (100-125 mg/dL) and 37 patients were diabetic with fasting blood glucose levels above 125 mg/dL.