[Prevalence of glucometabolic abnormalities in connection with myocardial infarction in a Danish coronary care unit]. / Forekomsten af patologisk glukosemetabolisme ved akut myokardieinfarkt på et dansk koronarafsnit.

ABSTRACT

BACKGROUND: The prevalence of previously undiscovered glucometabolic abnormalities such as diabetes and impaired glucose tolerance (IGT) has been shown to be high among selected groups with myocardial infarction. The aim of this study was to establish the prevalence of known diabetes and undiagnosed glucometabolic abnormalities in an unselected population with myocardial infarction (MI) at admission and after 3 months by use of oral glucose tolerance testing (OGTT). MATERIALS AND METHODS: During an 18-month period patients consecutively admitted with acute MI in a Danish coronary care unit were included. Out of the 218 patients included, 44 had known diabetes. Using the results of OGTT and fasting venous plasma glucose measures, the remaining 174 patients were classified in glucometabolic categories. 80 out of 111 invited patients were classified by OGTT after 3 months. RESULTS: 71% of the cohort had abnormal glucose metabolism, 29% IGT, 22% newly detected diabetes and 20% established diabetes. There were no significant differences in body mass index, blood pressure, cholesterol, HDL, LDL or triglycerides in the groups without known diabetes. Patients with abnormal glucose metabolism were older than their normal glucose tolerance counterparts. There was a trend towards normalization of glucometabolism after 3 months. CONCLUSION: The prevalence of abnormal glucose metabolism in MI-populations is high. Among individuals with presumably normal glucose tolerance 37% were classified as IGT and 27% as diabetics. Association between common risk factors for both abnormal glucose regulation and MI could not explain these findings. OGTT is probably required for correct diagnosis of abnormal glucose regulation in patients with MI.