Glucose fluctuation (GF) is a residual risk factor for coronary artery disease (CAD). We investigated whether GF influenced clinical outcomes and progression of coronary stenosis in stable CAD patients.
In this prospective study, 101 consecutive lipid-controlled stable CAD patients underwent percutaneous coronary intervention was enrolled and GF expressed as the mean amplitude of glycemic excursion (MAGE) obtained by continuous glucose monitoring before procedure was evaluated. At 9-month after enrollment, culprit and non-culprit (mild to moderate stenosis without ischemia) lesions were serially assessed by angiography. Cardiovascular events (CVE) consisting of cardiovascular death, non-fatal myocardial infarction or ischemia-driven revascularization during 2-year follow-up, rapid progression (RP) in non-culprit lesions (defined as ≥10% luminal narrowing progression in lesions with stenosis ≥50%, ≥30% luminal narrowing progression in non-culprit lesion with stenosis <50% or normal segment, or progression to total occlusion) were evaluated.
CVE occurred in 25 patients and MAGE was significantly higher in CVE group (76.1 ± 24.8 mg/dL vs. 59.3 ± 23.7 mg/dL; p=0.003). Multivariate analysis revealed that MAGE was an independent predictor of CVE (odds ratio, 1.027; 95% confidence interval [CI], 1.008-1.047; p=0.005). The optimal MAGE value to predict CVE was 70.7 mg/dL (Area under the curve 0.687; 95% CI, 0.572-0.802; p=0.005). Furthermore, MAGE was independently associated with RP, and with the luminal narrowing progression in all non-culprit lesions (r=0.400; p=0.05).
Daily GF may influence future CVE in lipid-controlled stable CAD patients.
© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.