(26-11-07) AHA 2007: Fasting plasma glucose levels predict CV events

The results of a large international study have provided further evidence suggesting that fasting plasma glucose levels predict incident cardiovascular events.

In the EpiDREAM multiethnic cohort study, a total of 19,049 individuals (screened for entry into the DREAM clinical trial; 61% were women) from 21 countries were prospectively followed for a median of 3.3 years.

Baseline testing showed that 50% were normoglycaemic, 37% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), and 13% had newly diagnosed diabetes. The prevalences of CVD at baseline were 2.1% in the normoglycaemic group, 2.8% in the IFG/IGT group, and 3.9% in the diabetes group.

In the follow-up period, there were a total of 455 incident CV events (nonfatal coronary heart disease, nonfatal stroke, or congestive heart failure requiring hospitalization) and deaths (from any cause), affecting 1.6% in the normoglycaemic group, 3.1% in the IFG/IGT group, and 3.36% in the diabetes group.

The CV event and death rate per 100 person-years was 0.48 in the normoglycaemic group, 0.95 in the IFG/IGT group, and 1.02 in the diabetes group.

Adjusted for confounding factors, including medication use at baseline and during the study, the relative risk of CV events or death compared with the normoglycaemic group was 1.29 for the IFG/IGT group (95% confidence interval 1.03-1.60), 1.19 for the diabetes group (95% confidence interval 0.90-1.57; nonsignificant), and 1.27 for a composite group of all people with any glucose intolerance (95% confidence interval 1.02-1.57).

Presenting the study results at the AHA conference, Sonia Anand from McMaster University in Hamilton, Canada, reported that a 1 mmol/L increase in fasting plasma glucose at baseline was associated with a 12% increase in CV events or death. She said the study findings show that clinical trials are warranted to determine if glucose lowering in non-diabetic subjects with elevated fasting plasma glucose levels is associated with a reduction in CV events.

Source: American Heart Association Scientific Sessions 2007, Orlando, USA, 4-7 November 2007, presentation number 3680.

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