The relationship between coronary artery disease and abnormal glucose regulation in China: the China Heart Survey

Aim The aim of this article is to characterize the glucometabolic state of patients with coronary artery disease (CAD) in China. Methods and results This multicentre study recruited 3513 patients hospitalized for CAD, of whom 35.1% were admissions for acute CAD and 64.9% were elective admissions for CAD. At entry, 1153 patients had known type 2 diabetes and 97 had newly diagnosed diabetes [fasting plasma glucose level (FPG) ≥7.0 mmol/L]. Oral glucose tolerance tests (OGTTs) performed in the remaining patients revealed that 26.9% had diabetes and 37.3% had impaired glucose regulation (IGR). The prevalence of abnormal glucose regulation (AGR) was similar in the acute and elective admissions groups. Overall, the proportion of patients with diagnosed diabetes increased from 32.8% at baseline to 52.9% post-OGTT analysis. In total, 87.4% of patients with IGR and 80.5% of patients with diabetes would have remained undiagnosed if OGTTs had not been performed. Conclusion AGR is common in patients with CAD. The prevalence of AGR is underestimated by FPG testing alone. OGTTs should be routinely used to assess the glucometabolic state of patients with CAD. Individuals identified with IGR or type 2 diabetes should receive treatment to reduce the progression of AGR and associated complications.