Value Of Impaired Glucose Regulation In Early Diagnosis And Prognosis Of Patients With Coronary Heart Disease

ObjectiveTo explore the value of impaired glucose regulation in early diagnosis and prognosis of patients with coronary heart disease.MethodsSelect 521 patients in our hospital with a clear diagnosis of coronary heart disease and selective coronary angiography in 2011 as CHD group,200 cases of outpatients who were excluded from CHD were used as the control group.To compare the occurrence of IGR in patients with coronary heart disease group and control group. Multiple Logistic regression analysis was conducted to analyze the risk factors of IGR. According to fasting blood glucose and OGTT test results, the CHD group was divided into three subgroups:normal glucose group(NGT) with 138 cases, impaired glucose regulation group(IGR) with 168 cases, and diabetes mellitus group(DM) with 215 cases.And to compare the similaritiesand differences of the characteristics of coronary artery lesions in three groups.All the study subjects were followed up for an average of3.5 years,to observe the main adverse cardiovascular events in patients, that isthe occurrence of MACCE eventsincluding non fatal stroke, non fatal myocardial infarction, heart failure, re-intervention therapy, and all due to death.Results(1)The CHD group of patients with abnormal glucose metabolism occurred in 73.5%, which is 32.2% IGR and DM 41.3%,and the incidence of IGR in the CHD group was significantly higher than that of the normal control group(21.5%), the difference is significant(x2=0.062, P = 0.005);(2)In the CHD group, 262 patients were newly found abnormal glucose metabolism, including 168 patients with IGR. These IGR patients included 54 patients with impaired fasting glucose(IFG), 114 patients with blood glucose was impaired after 2 hours(IGT).There were 94 cases of newly discovered DM patients, including 11 cases of fasting hyperglycemia(IFH), 83 cases of postprandial hyperglycemia(IPH).(3)The DM group and the IGR group in age, BMI, blood lipid levels and the number ofcombination of hypertension,family history of early onset ischemic cardiovascular disease was significantly higher than the NGT group(P<0.01), and there was no significant difference between the DM group and IGR group(P>0.05).(4)Multivariate regression analysis showed that age, history of hypertension, triglyceride, cholesterol, high density lipoprotein cholesterol were the risk factors of IGR.(5)Postprandial blood glucose, triglyceride levels, age, BMI, smoking history and family history of early onset ischemic cardiovascular disease were risk factors of CHD, and postprandial blood glucose was an independent risk factor of CHD.(6)The incidence of single vessel lesion in group DM and group IGR was lower than that in the normal blood glucose group, and the incidence of two branches and three branches vascular lesions in group DM and group IGR are significantly higher than those in groupNGT, all of the above were significant difference(P < 0.05), but there was no significant difference between the DM group and the IGR group(P>0.05).(7)During the mean follow-up period of 3.5 years, the incidence of MACCE events in group DM and group IGR was significantly higher than that in group NGT, the difference was significant(P<0.05), while there was no significant difference between group DM and group IGR(P>0.05).(8)Except for 215 patients with DM, the other subjects were divided into group IGR(+) and group IGR(-). The incidence of MACCE events in patients with group IGR(+) was significantly higher than that in group IGR(-)(P < 0.01) during the mean follow-up period of 3.5 years.ConclusionMost of the patients with coronary heart disease complicated with impaired glucose regulation,and these patients havean increasing risk of deeloping diabetes.The IGR not only can aggravate coronary lesions, and is associated with the occurrence of adverse cardiovascular events, affects the prognosis of patients.To recognize patients with abnormal glucose metabolism early has important clinical significance.