6.3 M ETHODOLOGICAL CONSIDERATIONS
6.3.2 Limitations
6.2.5 CABG and disturbances of glucose metabolism
Several studies have investigated the importance of unknown disturbances of glucose metabolism before CABG and the short and/or long-term prognosis. Thus far the results of these studies are inconclusive. One study including 244 patients, showed that the risk of early mortality after CABG in patients with known diabetes was similar to the mortality in patients with prediabetes and newly discovered diabetes (154). Another study indicated a strong association between the severity of disturbed glucose metabolism and cardiovascular events after CABG with the follow-up of only 6 months to 3 years (155). Holzmann et al demonstrated that patients with T2DM had a similar risk and that patients with T1DM had a two-fold risk of mortality (156).
Study III, which included 497 patients and a follow-up time of 10 years, showed that patients with prediabetes or newly discovered diabetes prior to CABG had similar long-term mortality compared to patients with normal glucose tolerance (85). These results are in line with the result from Holzman et al (156).
So far, research has shown that patients with ACS and diabetes have higher mortality and a poorer outcome compared to patients with normal glucose tolerance (3). However, this is contradicted by the result of study III which displayed no significant difference in mortality after CABG in patients with newly discovered hyperglycaemia vs normal glucose levels. This may be explained by the fact that CABG involves open-chest surgery, which is a major life event with more pain, discomfort, a longer rehabilitation period in comparison to PCI. By undergoing cardiac surgery patients might become more motivated to follow up treatment and compliance with recommendations when it comes to medication and lifestyle changes.
Furthermore, the diagnosis of diabetes and prediabetes before surgery may have had an impact on behaviour.
6.3 METHODOLOGICAL CONSIDERATIONS
In studies II and III, we only have information on laboratory values and medical treatment at the time of the index AMI. The effects of lifestyle modification and secondary preventive medical treatment that can affect the outcome cannot be analysed.
One limitation in study III was that HbA1c was not used routinely as a diagnostic tool at the beginning of the inclusion period. Most likely a selection bias was introduced, as there was a tendency to have an additional HbA1c analysed in those with a pathologic OGTT. Study III also had missing data for several variables. Therefore, only adjustments for age and sex were done and residual confounding may be present.
In study IV the results are based on admission glucose values and not a diabetes diagnosis. No determination of persistent hyperglycaemia could be made. For the same reason, the effectiveness of early or long-term anti-diabetes treatment or secondary prevention could not be assessed.
As in every observational study, a possibility of residual confounding by unmeasured factors cannot be eliminated.
7 CONCLUSION
In conclusion, HbA1c seems to be a better predictor than OGTT in identifying patients at risk for increased mortality and cardiovascular events after myocardial infarction. However, HbA1c does not identify as many patients with disturbances of glucose metabolism as OGTT. The importance of identifying more patients with hyperglycaemia versus identifying patients with an increased risk of mortality and cardiovascular events after myocardial infarction needs to be investigated further.
A majority of patients with cardiovascular events have undiagnosed disturbances of glucose tolerance and the long-term outcome in those patients is poorer compared to patients with normal glucose tolerance. Patients undergoing CABG with newly discovered dysglycaemia do not have a poorer outcome compared to patients with normal glucose tolerance. Patients with prediabetes and ACS have a higher rate of heart failure and reinfarction compared to patients with newly discovered diabetes and patients with normal glucose tolerance. It is important to highlight these results in order to understand the importance of the optimal strategy for multifactorial treatment in primary and secondary intervention and to find the best plan of action in helping these patients.
An elevated, random blood glucose test taken in the ED can identify patients with a higher risk of long-term mortality and cardiovascular events. This indicates that random blood glucose tests taken in the ED can help identify patients at risk and a strategy to improve their outcome could be considered.
8 ACKNOWLEDGEMENTS
I would like to express my greatest and most sincere gratitude to all the people that made this thesis possible. I also would like to express my gratitude to the patients and those who participated in these studies. In particular, I would like to thank:
Jeanette Kuhl, my principal tutor for introducing me to the field of disturbances of glucose metabolism and the world beyond clinical work. I still remember the day when I become your PhD student and it is a journey that has exceeded my wildest expectations. You are a role model in your work, with your attention to detail, enthusiasm, leadership and companionship. I am proud not only to have you as my principal tutor but also as a friend and I hope to follow in your footsteps.
Professor Martin Holzmann, my co-tutor, for his never-ending support and enthusiasm.
Through his eyes, everything was possible and to be a part of the whirlwind that was Professor Holzmann where everything happened with the utmost efficiency. Our collaboration was far too short, and you are deeply missed.
Professor Thomas Nyström, my co-tutor, for never-ending encouragement and support. For sharing his great knowledge in diabetology and research. For constructive criticism and helpful comments on manuscripts and attention to detail. I am grateful for your great collaboration and guidance and that you always had time for questions, no matter how big or small, which helped me to refine my own research skills.
Magnus Lundbäck, my co-tutor, for his enthusiasm, his great encouragement and support, for his constructive help and comments on the manuscript and valuable guidance.
Professor Ulrik Sartipy, co-author, for sharing his expertise in research, constructive criticism on manuscripts and for always being helpful.
Stelios Karayiannides, co-author, for being with me on this PhD journey together with your own thesis. For your patience and for always taking the time to explain and be helpful. For your great knowledge of diabetes, statistics and STATA.
Pia Lundman, co-author, for sharing your experience in research and for giving valuable recommendations.
My other co-authors, Anna Norhammar, Torbjörn Iverts, Majid Kalani and Gun Jörneskog for a pleasant collaboration and valuable comments on manuscripts.
My parents, Yvonne Förberg and Lars Djupsjö, for making me the person I am today.
Lance Sanderson for being such a great person and companion through the years and for supporting me in my research.
9 REFERENCES
1. Rafieian-Kopaei M, Setorki M, Doudi M, Baradaran A, Nasri H.
Atherosclerosis: process, indicators, risk factors and new hopes. Int J Prev Med. 2014
Aug;5(8):927-46. PubMed PMID: 25489440. PMCID: PMC4258672. Epub 2014/12/10. eng.
2. Kanters SD, Banga JD, Stolk RP, Algra A. Incidence and determinants of mortality and cardiovascular events in diabetes mellitus: a meta-analysis. Vascular medicine (London, England). 1999;4(2):67-75. PubMed PMID: 10406452. Epub 1999/07/16. eng.
3. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al.
Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet (London, England). 2010 Jun 26;375(9733):2215-22. PubMed PMID: 20609967. PMCID: PMC2904878. Epub
2010/07/09. eng.
4. Brunner EJ, Shipley MJ, Witte DR, Fuller JH, Marmot MG. Relation between blood glucose and coronary mortality over 33 years in the Whitehall Study. Diabetes care.
2006 Jan;29(1):26-31. PubMed PMID: 16373891. Epub 2005/12/24. eng.
5. Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendic S, Ryden L, et al.
Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet (London, England). 2002 Jun
22;359(9324):2140-4. PubMed PMID: 12090978. Epub 2002/07/02. eng.
6. Ritsinger V, Tanoglidi E, Malmberg K, Nasman P, Ryden L, Tenerz A, et al.
Sustained prognostic implications of newly detected glucose abnormalities in patients with acute myocardial infarction: long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort. Diabetes & vascular disease research. 2015
Jan;12(1):23-32. PubMed PMID: 25311248. Epub 2014/10/15. eng.
7. Barr EL, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, et al.
Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation. 2007 Jul 10;116(2):151-7. PubMed PMID:
17576864. Epub 2007/06/20. eng.
8. Lenzen M, Ryden L, Ohrvik J, Bartnik M, Malmberg K, Scholte Op Reimer W, et al. Diabetes known or newly detected, but not impaired glucose regulation, has a negative influence on 1-year outcome in patients with coronary artery disease: a report from the Euro Heart Survey on diabetes and the heart. European heart journal. 2006 Dec;27(24):2969-74.
PubMed PMID: 17090612. Epub 2006/11/09. eng.
9. WHO Guidelines Approved by the Guidelines Review Committee. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus: Abbreviated Report of a WHO Consultation. Geneva: World Health Organization
Copyright © World Health Organization 2011.; 2011.
10. George A, Bhatia RT, Buchanan GL, Whiteside A, Moisey RS, Beer SF, et al.
Impaired Glucose Tolerance or Newly Diagnosed Diabetes Mellitus Diagnosed during Admission Adversely Affects Prognosis after Myocardial Infarction: An Observational Study. PloS one. 2015;10(11):e0142045. PubMed PMID: 26571120. PMCID: PMC4646628.
Epub 2015/11/17. eng.
11. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes care. 1999 Feb;22(2):233-40.
PubMed PMID: 10333939. Epub 1999/05/20. eng.
12. Kiviniemi AM, Lepojarvi ES, Tulppo MP, Piira OP, Kentta TV, Perkiomaki JS, et al. Prediabetes and Risk for Cardiac Death Among Patients With Coronary Artery Disease:
The ARTEMIS Study. Diabetes care. 2019 May 10. PubMed PMID: 31076416. Epub 2019/05/12. eng.
13. Grant PJ, Cosentino F. The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: New features and the 'Ten Commandments' of the 2019 Guidelines are discussed by Professor Peter J. Grant and
Professor Francesco Cosentino, the Task Force chairmen. European heart journal. 2019 Oct 14;40(39):3215-7. PubMed PMID: 31608951. Epub 2019/10/15. eng.
14. Olvera Lopez E BB, Jan A. Cardiovascular disease: StatPearls [Internet].
Treasure Island (FL); 2021 [cited 2022. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK535419/
.
15. Kumar A, Cannon CP. Acute coronary syndromes: diagnosis and management, part I. Mayo Clin Proc. 2009 Oct;84(10):917-38. PubMed PMID: 19797781. PMCID:
PMC2755812. Epub 2009/10/03. eng.
16. Bajaj A, Sethi A, Rathor P, Suppogu N, Sethi A. Acute Complications of Myocardial Infarction in the Current Era: Diagnosis and Management. J Investig Med. 2015 Oct;63(7):844-55. PubMed PMID: 26295381. Epub 2015/08/22. eng.
17. Snipelisky D, Chaudhry SP, Stewart GC. The Many Faces of Heart Failure.
Card Electrophysiol Clin. 2019 Mar;11(1):11-20. PubMed PMID: 30717842. Epub 2019/02/06. eng.
18. Aronow WS. Peripheral arterial disease of the lower extremities. Arch Med Sci.
2012 May 9;8(2):375-88. PubMed PMID: 22662015. PMCID: PMC3361053. Epub 2012/06/05. eng.
19. Sarikaya H, Ferro J, Arnold M. Stroke prevention--medical and lifestyle measures. Eur Neurol. 2015;73(3-4):150-7. PubMed PMID: 25573327. Epub 2015/01/13.
eng.
20. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al.
Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016 Jan 26;133(4):e38-360. PubMed PMID: 26673558. Epub 2015/12/18. eng.
21. WHO. Cardiovascular Diseases (CVD) WHO.int: WHO; 2020 [April 4th 2020]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
22. Socialstyrelsen. Statikdatabas för hjärtinfarkter Stockholm: Socialstyrelsen;
2020 [updated Feb 20th, 2020. Available from: https://sdb.socialstyrelsen.se/if_hji/val.aspx.
23. Socialstyrelsen. Socialstyrelsen. Färre drabbas och dör av hjärtinfarkt 2019 [cited 2022, Jan 12th. Available from: https://sdb.socialstyrelsen.se/if_hji/val.aspx.
24. Anand SS, Islam S, Rosengren A, Franzosi MG, Steyn K, Yusufali AH, et al.
Risk factors for myocardial infarction in women and men: insights from the INTERHEART study. European heart journal. 2008 Apr;29(7):932-40. PubMed PMID: 18334475. Epub 2008/03/13. eng.
25. Gu K, Cowie CC, Harris MI. Mortality in adults with and without diabetes in a national cohort of the U.S. population, 1971-1993. Diabetes care. 1998 Jul;21(7):1138-45.
PubMed PMID: 9653609. Epub 1998/07/08. eng.
26. Henning RJ. Type-2 diabetes mellitus and cardiovascular disease. Future Cardiol. 2018 Nov;14(6):491-509. PubMed PMID: 30409037. Epub 2018/11/10. eng.
27. Matheus AS, Tannus LR, Cobas RA, Palma CC, Negrato CA, Gomes MB.
Impact of diabetes on cardiovascular disease: an update. Int J Hypertens. 2013;2013:653789.
PubMed PMID: 23533715. PMCID: PMC3603160. Epub 2013/03/28. eng.
28. Sarnak MJ, Amann K, Bangalore S, Cavalcante JL, Charytan DM, Craig JC, et al. Chronic Kidney Disease and Coronary Artery Disease: JACC State-of-the-Art Review.
Journal of the American College of Cardiology. 2019 Oct 8;74(14):1823-38. PubMed PMID:
31582143. Epub 2019/10/05. eng.
29. Whelton PK, Carey RM, Aronow WS, Casey DE, Jr., Collins KJ, Dennison Himmelfarb C, et al. 2017
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018 Jun;71(6):e13-e115. PubMed PMID:
29133356. Epub 2017/11/15. eng.
30. Wilhelmsson C, Vedin JA, Elmfeldt D, Tibblin G, Wilhelmsen L. Hypertension and myocardial infarction. J Chronic Dis. 1978 Mar;31(3):157-64. PubMed PMID: 670536.
Epub 1978/03/01. eng.
31. Siasos G, Tsigkou V, Kokkou E, Oikonomou E, Vavuranakis M, Vlachopoulos C, et al. Smoking and atherosclerosis: mechanisms of disease and new therapeutic
approaches. Curr Med Chem. 2014;21(34):3936-48. PubMed PMID: 25174928. Epub 2014/09/02. eng.
32. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and
cardiovascular disease: an update. Journal of the American College of Cardiology. 2004 May 19;43(10):1731-7. PubMed PMID: 15145091. Epub 2004/05/18. eng.
33. Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. Int J Sports Med. 2000 Jan;21(1):1-12. PubMed PMID: 10683091. Epub 2000/02/22. eng.
34. Buttar HS LT, Ravi N. Exp Clin Cardiol. 2005;. Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Experimental and clinical cardiology. 2005;10(4):229–249. PMCID: PMC2716237.
35. Ren J, Wu NN, Wang S, Sowers JR, Zhang Y. Obesity cardiomyopathy:
evidence, mechanisms, and therapeutic implications. Physiol Rev. 2021 Oct 1;101(4):1745-807. PubMed PMID: 33949876. PMCID: PMC8422427. Epub 2021/05/06. eng.
36. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al.
Fourth Universal Definition of Myocardial Infarction (2018). Journal of the American College of Cardiology. 2018 Oct 30;72(18):2231-64. PubMed PMID: 30153967. Epub 2018/08/30. eng.
37. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes care. 2018 Jan;41(Suppl 1):S13-s27. PubMed PMID: 29222373.
Epub 2017/12/10. eng.
38. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes care. 2021 Jan;44(Suppl 1):S15-s33. PubMed PMID: 33298413.
Epub 2020/12/11. eng.
39. Zhang H, Colclough K, Gloyn AL, Pollin TI. Monogenic diabetes: a gateway to precision medicine in diabetes. J Clin Invest. 2021 Feb 1;131(3). PubMed PMID: 33529164.
PMCID: PMC7843214 stock options in Roche. TIP receives research and salary support from the Regeneron Genetics Center and Regeneron Pharmaceuticals. Epub 2021/02/03. eng.
40. Suzuki S. [Secondary diabetes]. Nihon Rinsho. 1999 Mar;57(3):637-43.
PubMed PMID: 10199147. Epub 1999/04/13. jpn.
41. Ahlqvist E, Storm P, Käräjämäki A, Martinell M, Dorkhan M, Carlsson A, et al. Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. The lancet Diabetes & endocrinology. 2018 May;6(5):361-9. PubMed PMID: 29503172. Epub 2018/03/06. eng.
42. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet (London, England). 2009 May 23;373(9677):1798-807. PubMed PMID: 19465235. PMCID:
PMC3144755. Epub 2009/05/26. eng.
43. Van Cromphaut SJ. Hyperglycaemia as part of the stress response: the
underlying mechanisms. Best Pract Res Clin Anaesthesiol. 2009 Dec;23(4):375-86. PubMed PMID: 20108577. Epub 2010/01/30. eng.
44. Marik PE, Bellomo R. Stress hyperglycemia: an essential survival response!
Crit Care. 2013 Mar 6;17(2):305. PubMed PMID: 23470218. PMCID: PMC3672537. Epub 2013/03/09. eng.
45. Federation ID. IFD Diabetes Atlas Online2022 [updated November 8th 2021.
10th edition 2021:[Available from: https://diabetesatlas.org/.
46. Department of Information EaRW, Geneva. WHO methods and data sources for global burden of disease estimates 2000-2016. 2018.
47. Andersson T, Ahlbom A, Carlsson S. Diabetes Prevalence in Sweden at Present and Projections for Year 2050. PloS one. 2015;10(11):e0143084. PubMed PMID: 26619340.
PMCID: PMC4664416. Epub 2015/12/01. eng.
48. Diagnosis and classification of diabetes mellitus. Diabetes care. 2013 Jan;36 Suppl 1(Suppl 1):S67-74. PubMed PMID: 23264425. PMCID: PMC3537273. Epub 2013/01/04. eng.
49. Rajkumar V, Levine SN. Latent Autoimmune Diabetes. StatPearls. Treasure Island (FL): StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.; 2022.
50. Buzzetti R, Zampetti S, Maddaloni E. Adult-onset autoimmune diabetes:
current knowledge and implications for management. Nat Rev Endocrinol. 2017 Nov;13(11):674-86. PubMed PMID: 28885622. Epub 2017/09/09. eng.
51. Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. Lancet (London, England). 2016 Jun 4;387(10035):2340-8. PubMed PMID: 27302273. PMCID:
PMC5571740. Epub 2016/06/16. eng.
52. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes research and clinical practice. 2017 Jun;128:40-50. PubMed PMID:
28437734. Epub 2017/04/25. eng.
53. Bellou V, Belbasis L, Tzoulaki I, Evangelou E. Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PloS one.
2018;13(3):e0194127. PubMed PMID: 29558518. PMCID: PMC5860745. Epub 2018/03/21.
eng.
54. Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci. 2020 Aug 30;21(17).
PubMed PMID: 32872570. PMCID: PMC7503727. Epub 2020/09/03. eng.
55. DeFronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes. 1988 Jun;37(6):667-87. PubMed PMID:
3289989. Epub 1988/06/01. eng.
56. McCracken E, Monaghan M, Sreenivasan S. Pathophysiology of the metabolic syndrome. Clin Dermatol. 2018 Jan-Feb;36(1):14-20. PubMed PMID: 29241747. Epub 2017/12/16. eng.
57. Schwarz PE, Li J, Reimann M, Schutte AE, Bergmann A, Hanefeld M, et al.
The Finnish Diabetes Risk Score is associated with insulin resistance and progression towards type 2 diabetes. J Clin Endocrinol Metab. 2009 Mar;94(3):920-6. PubMed PMID:
19106274. Epub 2008/12/25. eng.
58. DeFronzo RA, Tripathy D. Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes care. 2009 Nov;32 Suppl 2:S157-63. PubMed PMID:
19875544. PMCID: PMC2811436. Epub 2009/11/13. eng.
59. Ahmed B, Sultana R, Greene MW. Adipose tissue and insulin resistance in obese. Biomed Pharmacother. 2021 May;137:111315. PubMed PMID: 33561645. Epub 2021/02/10. eng.
60. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuniga FA.
Association between insulin resistance and the development of cardiovascular disease.
Cardiovascular diabetology. 2018 Aug 31;17(1):122. PubMed PMID: 30170598. PMCID:
PMC6119242. Epub 2018/09/02. eng.
61. Lencioni C, Lupi R, Del Prato S. Beta-cell failure in type 2 diabetes mellitus.
Curr Diab Rep. 2008 Jun;8(3):179-84. PubMed PMID: 18625113. Epub 2008/07/16. eng.
62. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC.
Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412-9. PubMed PMID: 3899825. Epub 1985/07/01. eng.
63. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes care. 1992 Jul;15(7):815-9. PubMed PMID:
1516497. Epub 1992/07/01. eng.
64. Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson AM, et al.
Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. The New England journal of medicine. 2018 Aug 16;379(7):633-44. PubMed PMID: 30110583.
Epub 2018/08/16. eng.
65. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. The New England journal of medicine. 2011 Mar 3;364(9):829-41. PubMed PMID: 21366474.
PMCID: PMC4109980. Epub 2011/03/04. eng.
66. Grundy SM, Pasternak R, Greenland P, Smith S, Jr., Fuster V. AHA/ACC scientific statement: Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Journal of the American College of Cardiology. 1999 Oct;34(4):1348-59. PubMed PMID: 10520820. Epub 1999/10/16. eng.
67. Tancredi M, Rosengren A, Svensson AM, Kosiborod M, Pivodic A,
Gudbjörnsdottir S, et al. Excess Mortality among Persons with Type 2 Diabetes. The New England journal of medicine. 2015 Oct 29;373(18):1720-32. PubMed PMID: 26510021.
Epub 2015/10/29. eng.
68. Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between
prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis.
BMJ (Clinical research ed). 2020 Jul 15;370:m2297. PubMed PMID: 32669282. PMCID:
PMC7362233 www.icmje.org/coi_disclosure.pdf (available on request from the
corresponding author) and declare: support from the Guangdong Basic and Applied Basic Research Fund, Science and Technology Innovation Project, and Clinical Research Startup Programme of Shunde Hospital, Southern Medical University for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. Epub 2020/07/17. eng.
69. Zand A, Ibrahim K, Patham B. Prediabetes: Why Should We Care? Methodist Debakey Cardiovasc J. 2018 Oct-Dec;14(4):289-97. PubMed PMID: 30788015. PMCID:
PMC6369626. Epub 2019/02/23. eng.
70. Ford ES, Zhao G, Li C. Pre-diabetes and the risk for cardiovascular disease: a systematic review of the evidence. Journal of the American College of Cardiology. 2010 Mar 30;55(13):1310-7. PubMed PMID: 20338491. Epub 2010/03/27. eng.
71. Kosiborod M, Rathore SS, Inzucchi SE, Masoudi FA, Wang Y, Havranek EP, et al. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation. 2005 Jun 14;111(23):3078-86. PubMed PMID: 15939812. Epub 2005/06/09. eng.
72. Bartnik M, Malmberg K, Norhammar A, Tenerz A, Ohrvik J, Ryden L. Newly detected abnormal glucose tolerance: an important predictor of long-term outcome after myocardial infarction. European heart journal. 2004 Nov;25(22):1990-7. PubMed PMID:
15541834. Epub 2004/11/16. eng.
73. Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendíc S, Rydén L, et al.
Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet (London, England). 2002 Jun
22;359(9324):2140-4. PubMed PMID: 12090978. Epub 2002/07/02. eng.
74. Dave JA, Engel ME, Freercks R, Peter J, May W, Badri M, et al. Abnormal glucose metabolism in non-diabetic patients presenting with an acute stroke: prospective study and systematic review. Qjm. 2010 Jul;103(7):495-503. PubMed PMID: 20430755.
Epub 2010/05/01. eng.
75. Lehrke M, Marx N. Diabetes Mellitus and Heart Failure. Am J Cardiol. 2017 Jul 1;120(1s):S37-s47. PubMed PMID: 28606342. Epub 2017/06/14. eng.
76. Kenny HC, Abel ED. Heart Failure in Type 2 Diabetes Mellitus. Circulation research. 2019 Jan 4;124(1):121-41. PubMed PMID: 30605420. PMCID: PMC6447311.
Epub 2019/01/04. eng.
77. Echouffo-Tcheugui JB, Xu H, DeVore AD, Schulte PJ, Butler J, Yancy CW, et al. Temporal trends and factors associated with diabetes mellitus among patients hospitalized with heart failure: Findings from Get With The Guidelines-Heart Failure registry. American heart journal. 2016 Dec;182:9-20. PubMed PMID: 27914505. Epub 2016/12/05. eng.
78. Farkouh ME, Domanski M, Sleeper LA, Siami FS, Dangas G, Mack M, et al.
Strategies for multivessel revascularization in patients with diabetes. The New England journal of medicine. 2012 Dec 20;367(25):2375-84. PubMed PMID: 23121323. Epub 2012/11/06. eng.
79. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. The New England journal of medicine. 1996 Jul 25;335(4):217-25.
PubMed PMID: 8657237. Epub 1996/07/25. eng.
80. Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2019 Jan 1;55(1):4-90. PubMed PMID: 30165632. Epub 2018/08/31. eng.
81. Farkouh ME, Domanski M, Dangas GD, Godoy LC, Mack MJ, Siami FS, et al.
Long-Term Survival Following Multivessel Revascularization in Patients With Diabetes: The FREEDOM Follow-On Study. Journal of the American College of Cardiology. 2019 Feb 19;73(6):629-38. PubMed PMID: 30428398. Epub 2018/11/15. eng.
82. Leavitt BJ, Sheppard L, Maloney C, Clough RA, Braxton JH, Charlesworth DC, et al. Effect of diabetes and associated conditions on long-term survival after coronary artery bypass graft surgery. Circulation. 2004 Sep 14;110(11 Suppl 1):Ii41-4. PubMed PMID: 15364836. Epub 2004/09/15. eng.
83. Alserius T, Hammar N, Nordqvist T, Ivert T. Risk of death or acute myocardial infarction 10 years after coronary artery bypass surgery in relation to type of diabetes.
American heart journal. 2006 Sep;152(3):599-605. PubMed PMID: 16923437. Epub 2006/08/23. eng.
84. Zhang X, Wu Z, Peng X, Wu A, Yue Y, Martin J, et al. Prognosis of diabetic patients undergoing coronary artery bypass surgery compared with nondiabetics: a systematic review and meta-analysis. Journal of cardiothoracic and vascular anesthesia. 2011
Apr;25(2):288-98. PubMed PMID: 21147538. Epub 2010/12/15. eng.
85. Djupsjo C SU, Ivert T et al. Preoperative Disturbances of Glucose Metabolism and Mortality after Coronary Artery Bypass Grafting. Open Heart. 2020.
86. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach:
update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care. 2015 Jan;38(1):140-9. PubMed PMID:
25538310. Epub 2014/12/30. eng.