DALLAS – Postmenopausal women with coronary artery disease and no diabetes who had a high-normal response to an oral glucose tolerance test had faster progression of atherosclerosis, compared with women who have lower glucose levels following an oral challenge.
This finding in a total of 51 patients suggests that an oral glucose tolerance test may help identify women who have an increased risk for progression of atherosclerosis, Dr. Philip B. Mellen and his associate reported in a poster presented at the annual scientific sessions of the American Heart Association.
The results also raise questions about optimal glucose levels in women with coronary artery disease who undergo a glucose tolerance test, wrote Dr. Mellen, a cardiologist at Wake Forest University in Winston-Salem, N.C.
The study involved 51 postmenopausal women with angiographically documented coronary artery disease and no history of diabetes. Their average age was 65 years. Their fasting levels of serum glucose were all within the normal range of 100 mg/dL or less, and their serum level of glucose 2 hours following an oral glucose challenge was also in the normal range of 140 mg/dL or less.
All of the participants underwent repeat coronary angiography 3 years later, and the change in their minimal lumen diameter in an affected coronary artery was correlated with their baseline glucose levels following an oral glucose challenge.
Patients with a serum glucose level of less than 87 mg/dL after challenge at baseline had atherosclerosis regression during follow-up, with their coronary lumen diameter increasing by an average of 0.044 mm.
Patients with a serum glucose level of 87-106 mg/dL after challenge at baseline showed an average 0.039 mm loss in lumen diameter during follow-up.
Patients whose serum glucose level was 107-123 mg/dL after challenge at baseline had an average 0.140-mm loss in coronary lumen diameter, and patients whose serum glucose level was 124-140 mg/dL or more after challenge at baseline had an average 0.185-mm loss in lumen diameter.
The trend of increased progression of atherosclerosis in women with higher serum glucose levels following challenge was statistically significant.
In contrast, no correlation was seen between fasting levels of serum glucose and progression of atherosclerosis.