Viveca Gyberg1, Dirk De Bacquer2, Kornelia Kotseva3, Guy De Backer2, Oliver Schnell4, Jouko Sundvall5, Jaakko Tuomilehto6, David Wood7, Lars Rydén8. 1. Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm 171 76, Sweden Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden vivecagyberg@gmail.com. 2. Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Department of Public Health, Ghent University, Ghent, Belgium. 3. Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. 4. Forschergruppe Diabetes e.V. at the Helmholtz Center, Munich, Germany. 5. Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Disease Risk Unit, National Institute for Health and Welfare, Helsinki, Finland. 6. Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Centre for Vascular Prevention, Danube-University Krems, Krems, Austria Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland Instituto de Investigacion Sanitaria del Hospital Universario LaPaz (IdiPAZ), Madrid, Spain Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia. 7. Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK. 8. Fellow of the European Society of Cardiology, Les Templiers, 2035 Route des Colles, CS 80179 BIOT, Sophia Antipolis Cedex 06903, France Cardiology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm 171 76, Sweden.
Abstract
AIMS: Three methods are used to identify dysglycaemia: fasting plasma glucose (FPG), 2-h post-load plasma glucose (2hPG) from the oral glucose tolerance test (OGTT), and glycated haemoglobin A1c (HbA1c). The aim was to describe the yield and concordance of FPG, HbA1c, and 2hPG alone, or in combination, to identify dysglycaemia in patients with coronary artery disease. METHODS AND RESULTS: In EUROASPIRE IV, a cross-sectional survey of patients aged 18-80 years with coronary artery disease in 24 European countries, 4004 patients with no reported history of diabetes had FPG, 2hPG, and HbA1c measured. All participants were divided into different glycaemic categories according to the ADA and WHO criteria for dysglycaemia. Using all screening tests together, 1158 (29%) had undetected diabetes. Out of them, the proportion identified by FPG was 75%, by 2hPG 40%, by HbA1c 17%, by FPG + HbA1c 81%, and by OGTT (=FPG + 2hPG) 96%. Only 7% were detected by all three methods FPG, 2hPG, and HbA1c. The ADA criteria (FPG + HbA1c) identified 90% of the population as having dysglycaemia compared with 73% with the WHO criteria (OGTT = FPG + 2hPG). Screening according to the ADA criteria for FPG + HbA1c identified 2643 (66%) as having a 'high risk for diabetes', while the WHO criteria for FPG + 2hPG identified 1829 patients (46%). CONCLUSION: In patients with established coronary artery disease, the OGTT identifies the largest number of patients with previously undiagnosed diabetes and should be the preferred test when assessing the glycaemic state of such patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Three methods are used to identify dysglycaemia: fasting plasma glucose (FPG), 2-h post-load plasma glucose (2hPG) from the oral glucose tolerance test (OGTT), and glycated haemoglobin A1c (HbA1c). The aim was to describe the yield and concordance of FPG, HbA1c, and 2hPG alone, or in combination, to identify dysglycaemia in patients with coronary artery disease. METHODS AND RESULTS: In EUROASPIRE IV, a cross-sectional survey of patients aged 18-80 years with coronary artery disease in 24 European countries, 4004 patients with no reported history of diabetes had FPG, 2hPG, and HbA1c measured. All participants were divided into different glycaemic categories according to the ADA and WHO criteria for dysglycaemia. Using all screening tests together, 1158 (29%) had undetected diabetes. Out of them, the proportion identified by FPG was 75%, by 2hPG 40%, by HbA1c 17%, by FPG + HbA1c 81%, and by OGTT (=FPG + 2hPG) 96%. Only 7% were detected by all three methods FPG, 2hPG, and HbA1c. The ADA criteria (FPG + HbA1c) identified 90% of the population as having dysglycaemia compared with 73% with the WHO criteria (OGTT = FPG + 2hPG). Screening according to the ADA criteria for FPG + HbA1c identified 2643 (66%) as having a 'high risk for diabetes', while the WHO criteria for FPG + 2hPG identified 1829 patients (46%). CONCLUSION: In patients with established coronary artery disease, the OGTT identifies the largest number of patients with previously undiagnosed diabetes and should be the preferred test when assessing the glycaemic state of such patients. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: S Störk; P U Heuschmann; K Ungethüm; S Wiedmann; M Wagner; R Leyh; G Ertl; S Frantz; T Geisler; W Karmann; R Prondzinsky; C Herdeg; M Noutsias; T Ludwig; J Käs; B Klocke; J Krapp; D Wood; K Kotseva Journal: Clin Res Cardiol Date: 2022-09-27 Impact factor: 6.138
Authors: Dirk De Bacquer; Delphine De Smedt; Kornelia Kotseva; Catriona Jennings; David Wood; Lars Rydén; Viveca Gyberg; Bahira Shahim; Philippe Amouyel; Jan Bruthans; Almudena Castro Conde; Renata Cífková; Jaap W Deckers; Johan De Sutter; Mirza Dilic; Maryna Dolzhenko; Andrejs Erglis; Zlatko Fras; Dan Gaita; Nina Gotcheva; John Goudevenos; Peter Heuschmann; Aleksandras Laucevicius; Seppo Lehto; Dragan Lovic; Davor Miličić; David Moore; Evagoras Nicolaides; Raphael Oganov; Andrzej Pajak; Nana Pogosova; Zeljko Reiner; Martin Stagmo; Stefan Störk; Lale Tokgözoğlu; Dusko Vulic; Martin Wagner; Guy De Backer Journal: Eur J Epidemiol Date: 2018-10-23 Impact factor: 8.082
Authors: Viveca Gyberg; Dirk De Bacquer; Guy De Backer; Catriona Jennings; Kornelia Kotseva; Linda Mellbin; Oliver Schnell; Jaakko Tuomilehto; David Wood; Lars Rydén; Philippe Amouyel; Jan Bruthans; Almudena Castro Conde; Renata Cifkova; Jaap W Deckers; Johan De Sutter; Mirza Dilic; Maryna Dolzhenko; Andrejs Erglis; Zlatko Fras; Dan Gaita; Nina Gotcheva; John Goudevenos; Peter Heuschmann; Aleksandras Laucevicius; Seppo Lehto; Dragan Lovic; Davor Miličić; David Moore; Evagoras Nicolaides; Raphael Oganov; Andrzej Pająk; Nana Pogosova; Zeljko Reiner; Martin Stagmo; Stefan Störk; Lale Tokgözoğlu; Dusko Vulic Journal: Cardiovasc Diabetol Date: 2015-10-01 Impact factor: 9.951
Authors: Bahira Shahim; Viveca Gyberg; Dirk De Bacquer; Kornelia Kotseva; Guy De Backer; Oliver Schnell; Jaakko Tuomilehto; David Wood; Lars Rydén Journal: Cardiovasc Diabetol Date: 2018-01-24 Impact factor: 9.951
Authors: Viveca Gyberg; Dirk De Bacquer; Kornelia Kotseva; Guy De Backer; Oliver Schnell; Jaakko Tuomilehto; David Wood; Lars Rydén Journal: BMJ Open Date: 2016-12-08 Impact factor: 2.692