Altered fasting glycemia is the most sensitive risk factor of coronary atersclerotic disease in Colombian patients with angina pectoris

Abstract

Background. The presence of DM2 is associated to two to four times higher risk of having coronary disease compared to non diabetic subjects. The American Diabetes Association recently defined DM2 with glycemia of More than 126 mg/dl due to the high risk of micro-vasculopaties at those levels. However, impaired fasting glycemia levels (more than 100 mg/dl and less than 126mg/dl ) have been associated to an increased risk of mortality and morbidity due to cardiovascular disease. This study assesses the relationship between impaired fasting glycemia and the presence of atherosclerotic coronary disease established by coronary angiography.

Methods. Case and control study including patients that enter the Homodynamic service for elective coronary angiography for chest pain study. The patients that had ≥30% occlusion of a main coronary artery or ≥50% occlusion of a secondary coronary artery. All patients had a complete clinical history taken, anthropometric measurements and fasting blood samples for biochemical determinations.

Results. 141 patients, 64 cases and 77 controls were included, 69 women (48.9%) and 72 men (51.1%). The older patients (64.1 years more or less 8.6 vs. 58.5 years more or less 10.4, p=0-0016), presented higher systolic arterial blood pressure (130.5 mmHg more or less 20-99 vs. 130.0 mmGh more or less 18.45, p=0.0283), more abdominal perimeter (91.5 cm more or less 10-7 vs. 86.27 cm more or less 12.93, p=0.0005) and waist-hip relationship (0.94 more or less 0.122 vs. 0.91 more or less 0.142, p=0.016). Fasting glycemia was higher in the cases ( 112.0 mg/dl more or les 38.35 vs. 96.0 mg/ dl more or less 25.01, p=0-0003). The logistic regression model glycemia higher than 100 mg/dl was the only risk factor that was independently associated to coronary disease