Oral glucose tolerance test – a reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice -A report on repeated oral glucose tolerance tests from the GAMI study

doi:10.2337/dc07-1552

Oral glucose tolerance test – a reliable tool for early detection of glucose abnormalities in patients with acute myocardial infarction in clinical practice -A report on repeated oral glucose tolerance tests from the GAMI study

M. Wallander, MD (marit.wallander{at}ki.se)^a,
K. Malmberg, MD, PhD^a,
A Norhammar, MD, PhD^a,
L. Rydén, MD, PhD^a and
Å Tenerz, MD, PhD^b

^a Cardiology, Karolinska University Hospital Solna, Stockholm, Sweden
^b Medicine, Central Hospital, Västerås, Sweden

Abstract

Objective: Previously undetected glucose abnormalities are common in patients with acute myocardial infarction (AMI). We evaluated long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTT).

Research Design and Methods: A glucometabolic, OGTT-based classification was obtained in 122 patients, measuring capillary whole blood glucose. The classification was performed at three occasions, before hospital discharge and 3 and 12 months thereafter.

Results: At discharge, 34, 31 and 34% were classified as NGT, IGT or type 2 diabetes respectively and 93 % of all patients with type 2 diabetes were still classified with type 2 diabetes (n=27) or IGT (n=12), after 12 months. The agreements between the OGTTs at discharge, 3 and 12 months were: discharge-3M: kappa=0.35, p<0.001 and discharge-12M: kappa= 0.43, p<0.001.

Conclusions: The outcome of an OGTT performed in AMI patients at hospital discharge reliably informs on the long-term glucometabolic state.