2-h postchallenge plasma glucose predicts cardiovascular events in patients with myocardial infarction without known diabetes mellitus.

BACKGROUND AND PURPOSE: The incidence of cardiovascular events remains high in patients with myocardial infarction (MI) despite advances in current therapies. New and better methods for identifying patients at high risk of recurrent cardiovascular (CV) events are needed. This study aimed to analyze the predictive value of an oral glucose tolerance test (OGTT) in patients with acute myocardial infarction without known diabetes mellitus (DM).

METHODS: The prospective cohort study consisted of 123 men and women aged between 31-80 years who had suffered a previous MI 3-12 months before the examinations. The exclusion criteria were known diabetes mellitus. Patients were followed up over 6.03 ± 1.36 years for CV death, recurrent MI, stroke and unstable angina pectoris. A standard OGTT was performed at baseline.

RESULTS: 2-h plasma glucose (HR, 1.27, 95% CI, 1.00 to 1.62; P < 0.05) and smoking (HR, 3.56, 95% CI, 1.02 to 12.38; P < 0.05) proved to be independent predictors of CV events in multivariate statistical analysis after adjustments for age, sex, total cholesterol, and other baseline characteristics.

CONCLUSIONS: In this study population, with previous MI and without known DM, 2-h PG and smoking were significant predictors of CV death, recurrent MI, stroke and unstable angina pectoris, independent of baseline characteristics and medical treatment.