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Diagnostic value of markers of carbohydratemetabolism disorders in patients with coronaryartery disease before planned percutaneouscoronary intervention

Authors: Ignatova Yu.S.1, Karetnikova V.N.1,2, 2, Kochergina A.M.1,2, 2, Gruzdeva O.V.2, Khorlampenko A.A.2, Zagorodnikov N.I.1, Kuz'mina A.A.2, Barbarash O.L.1,2, 2

Company: 1Kemerovo State Medical University of Ministry of Health of the Russian Federation, ulitsa Voroshilova, 22a, Kemerovo, 650029, Russian Federation;
2Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2018-12-3-211-224

For citation: Ignatova Yu.S., Karetnikova V.N., Kochergina A.M., Gruzdeva O.V., Khorlampenko A.A., Zagorodnikov N.I., Kuz'mina A.A., Barbarash O.L. Diagnostic value of markers of carbohydrate metabolism disorders in patients with coronary artery disease before planned percutaneous coronary intervention. Creative Cardiology. 2018; 12 (3): 211–24 (in Russ.). DOI: 10.24022/1997-3187-2018-12-3-211-224

Received / Accepted:  09.02.2018/09.04.2018

Keywords: carbohydrate metabolism disorders markers coronary artery disease percutaneous coronary intervention

Full text:  

 

Abstract

Objective. To determine the diagnostic significance of carbohydrate metabolism disorders (CMD) markers in patients with coronary artery disease (CAD) and indications for percutaneous coronary intervention (PCI).

Material and methods. A prospective study was conducted during the period from August 2017 to November 2017 among patients admitted to the planned PCI in Research Institute for Complex Issues of Cardiovascular Diseases. Diagnosis of CMD was based on the diagnostic level of blood glucose, glycated hemoglobin (HbA1c), and postprandial blood glucose. Concentrations of fructosamine and 1.5-anhydroglucitol (1.5-AG) were studied as additional markers of CMD.

Results. Of the 140 patients, 54 (38.6%) were diagnosed for the first time with different types of CMD by the level fasting glucose, HbA1c and postprandial blood glucose: 15.7% had diabetes, 9.3% had impaired glucose tolerance (IGT), 13.6% – impaired fasting glycemia (IFG). Based on the results of the ROC analysis, the diagnostic value of fasting glucose in diabetes and IFG was proved (р <0.001). In the case of postprandial blood glucose, there was no reliable diagnostic value for all CMD. HbA1c more than 6.3% had a 72.1% sensitivity with diabetes (AUC 0.908; 95% CI 0.846–0.952; р <0.001), and HbA1c more than 5.3% for IFG (AUC 0.714; 95% CI 0.595–0.814; р=0,00). The concentration level of fructosamine more than 305 μmol / l was associated with the presence of diabetes (AUC 0.793; 95% CI 0.716–0.857; р <0.001). The sensitivity and specificity of 1.5-AG was unreliable for all CMD.

Conclusions. In patients with CHD and indications for PCI, the diagnostic value of fasting glucose and HbA1c for
diabetes and IFG and fructosamine for diabetes were demonstrated. Postprandial blood glucose and 1.5-AG did
not show any diagnostic value in any variant of CMD.

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About Authors

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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