Glucose fluctuations in CAD patients tied to future CV events

Daily glucose fluctuations (GF) may be indicative of future cardiovascular events (CVEs) in patients with stable, lipid-controlled coronary artery disease (CAD), a new study has found.

Researchers conducted a prospective analysis of 101 stable CAD patients (mean age, 70.8±10.4 years; 78 percent male) who underwent percutaneous coronary intervention (PCI). Participants were on continuous glucose monitoring before the procedure, and GF was expressed as the mean amplitude of glycaemic excursion (MAGE).

The primary outcome was CVEs, which consisted of cardiovascular death, nonfatal myocardial infarction, or ischaemia-driven revascularization. Over 2 years of follow-up, 25 patients developed such events, the most common of which was target vascular revascularization.

While there were no differences in lipid and glucose levels between patients who did vs did not develop CVEs, disparities were detected in MAGE, maximum blood glucose concentration, and time in hyperglycaemia. In particular, MAGE was significantly higher in patients who experienced CVEs (76.1±24.8 vs 59.3±23.7 mg/dL; p=0.003).

The same was true for peak glucose (242.0±63.3 vs 208.9±52.5 mg/dL; p=0.01) and time in hyperglycaemia (44.5±29.6 percent vs 29.2±29.3 percent; p=0.03).

Multivariate logistic regression analysis confirmed the significant and independent effect of MAGE on the risk of CVEs (odds ratio, 1.027, 95 percent confidence interval, 1.008–1.047; p=0.005).

“Daily glucose fluctuations may be associated with the progression of both target and nontarget lesions following PCI, resulting in increased cardiovascular events, even in stable CAD patients undergoing lipid lowering therapy. Therefore, daily glucose fluctuations may be a potential target for reducing future cardiovascular events,” the researchers said.