Giulia Ferrannini1,2, Dirk De Bacquer3,4, Guy De Backer3,4, Kornelia Kotseva3,5,6, Linda Mellbin2,3, David Wood3,5,6, Lars Rydén. 1. Department of Medical Sciences, Postgraduate School of Internal Medicine, University of Turin, Turin, Italy. 2. Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 3. European Society of Cardiology, Sophia Antipolis, France. 4. Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. 5. National Institute for Prevention and Cardiovascular Health, National University of Ireland-Galway, Galway, Republic of Ireland. 6. National Heart and Lung Institute, Imperial College London, London, U.K.
Abstract
OBJECTIVE: Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS: The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS: A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS: Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
OBJECTIVE: Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS: The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CADpatients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS: A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS: Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
Authors: John William McEvoy; Catriona Jennings; Kornelia Kotseva; Guy De Backer; Dirk De Bacquer; Iris Erlund; Gregory Y H Lip; Kausik K Ray; Lars Rydén; Agnieszka Adamska; David A Wood Journal: Curr Cardiol Rep Date: 2021-08-19 Impact factor: 2.931
Authors: Giulia Ferrannini; Dirk De Bacquer; Pieter Vynckier; Guy De Backer; Viveca Gyberg; Kornelia Kotseva; Linda Mellbin; Anna Norhammar; Jaakko Tuomilehto; David Wood; Lars Rydén Journal: Cardiovasc Diabetol Date: 2021-02-11 Impact factor: 9.951
Authors: Małgorzata Chlabicz; Jacek Jamiołkowski; Wojciech Łaguna; Paweł Sowa; Marlena Paniczko; Magda Łapińska; Małgorzata Szpakowicz; Natalia Drobek; Andrzej Raczkowski; Karol A Kamiński Journal: J Clin Med Date: 2021-04-09 Impact factor: 4.241
Authors: Stefan Roest; Marleen M Goedendorp-Sluimer; Julia J Köbben; Alina A Constantinescu; Yannick J H J Taverne; Felix Zijlstra; Adrienne A M Zandbergen; Olivier C Manintveld Journal: Transpl Int Date: 2022-04-19 Impact factor: 3.842
Authors: Natalia Drobek; Paweł Sowa; Piotr Jankowski; Maciej Haberka; Zbigniew Gąsior; Dariusz Kosior; Danuta Czarnecka; Andrzej Pająk; Karolina Szostak-Janiak; Agnieszka Krzykwa; Małgorzata Setny; Paweł Kozieł; Marlena Paniczko; Jacek Jamiołkowski; Irina Kowalska; Karol Kamiński Journal: J Clin Med Date: 2021-05-05 Impact factor: 4.241