TY - JOUR
T1 - Screening for glucose perturbations and risk factor management in dysglycemic patients with coronary artery diseaseda persistent challenge in need of substantial improvement
T2 - A Report From ESC EORP EUROASPIRE V
AU - EUROASPIRE V collaborators
AU - Ferrannini, Giulia
AU - De Bacquer, Dirk
AU - De Backer, Guy
AU - Kotseva, Kornelia
AU - Mellbin, Linda
AU - Wood, David
AU - Rydén, Lars
AU - Study group members AMC, null
AU - Peters, R. J. G.
AU - Scholte op Reimer, W. J. M.
AU - Snaterse-Zuidam, M.
N1 - Funding Information: Acknowledgment.TheEUROASPIREStudyGroup is grateful to the administrative staff, physicians, nurses, and other personnel in the hospitals in which the survey was performed and to all patients who participated in the surveys, as well as to the European Observational Research Programme Oversight Committee, Registry Executive and Steering Committees. Data collection wasconductedbytheEORPdepartmentfromthe ESC by Project Officer Emanuela Fiorucci and Data Managers Viviane Missiamenou and Florian Larras. All investigators are listed in the Supplementary Data online. Funding and Duality of Interest. The EURO-ASPIRE V was performed under the auspices of the European Society of Cardiology, EURObser-vational Research Programme. The survey was supported through research grants to the European Society of Cardiology from Amgen, Daiichi Sankyo, Eli Lilly, Pfizer, Sanofi, Ferrer, and Novo Nordisk. Publisher Copyright: © 2020 by the American Diabetes Association. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - OBJECTIVE: Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.RESEARCH DESIGN AND METHODS: The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated.RESULTS: A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small.CONCLUSIONS: Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
AB - OBJECTIVE: Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.RESEARCH DESIGN AND METHODS: The European Society of Cardiology's European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016-2017) included 8,261 CAD patients, aged 18-80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated.RESULTS: A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium-glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small.CONCLUSIONS: Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Blood Glucose/analysis
KW - Coronary Artery Disease/blood
KW - Diabetes Mellitus, Type 2/complications
KW - Europe/epidemiology
KW - Female
KW - Glucose Intolerance/complications
KW - Glucose Metabolism Disorders/complications
KW - Glucose Tolerance Test
KW - Health Services Needs and Demand/organization & administration
KW - Humans
KW - Male
KW - Mass Screening/methods
KW - Middle Aged
KW - Primary Prevention/methods
KW - Program Evaluation
KW - Quality Improvement
KW - Risk Factors
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85082147214&partnerID=8YFLogxK
U2 - https://doi.org/10.2337/dc19-2165
DO - https://doi.org/10.2337/dc19-2165
M3 - Article
C2 - 32079627
SN - 0149-5992
VL - 43
SP - 726
EP - 733
JO - Diabetes Care
JF - Diabetes Care
IS - 4
ER -