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Concordance of glucose based and of HbA1c based diagnoses of diabetes in patients with established coronary atherosclerosis: a comparison between men and women

Session Poster session 4

Speaker Christoph Saely

Event : ESC Congress 2015

  • Topic : preventive cardiology
  • Sub-topic : Metabolic Syndrome, Insulin, Insulin Resistance
  • Session type : Poster Session

Authors : CH Saely (Feldkirch,AT), D Zanolin (Triesen,LI), P Rein (Feldkirch,AT), A Vonbank (Feldkirch,AT), A Leiherer (Feldkirch,AT), G Naerr (Triesen,LI), A Muendlein (Feldkirch,AT), H Drexel (Philadelphia,US)

C.H. Saely1 , D. Zanolin2 , P. Rein1 , A. Vonbank1 , A. Leiherer3 , G. Naerr2 , A. Muendlein3 , H. Drexel4 , 1Academic Teaching Hospital, Department of Medicine and Cardiology - Feldkirch - Austria , 2Private University of the Principality of Liechtenstein - Triesen - Liechtenstein , 3VIVIT Institute - Feldkirch - Austria , 4Drexel University College of Medicine - Philadelphia - United States of America ,

European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 642

Background and introduction: Concordance between glucose based and HbA1c based diagnoses of diabetes differ between populations.

Purpose: The purpose of our study was to investigate their concordance in men and in women with stable coronary artery disease (CAD).

Methods: We measured fasting glucose as well as HbA1c and performed standard 75g oral glucose tolerance tests in a consecutive series of 711 patients, 513 men and 198 women, who had angiographically proven coronary artery disease (CAD) but not previously diagnosed diabetes. Based on glucose values, diabetes was diagnosed with a fasting plasma glucose (FPG) ≥126 mg/dl or a postchallenge glucose ≥200 mg/dl 2 hours after the oral glucose load; based on HbA1c values diabetes was diagnosed with an HbA1c ≥6.5%.

Results: Among men, 33 had diabetes based on fasting or postchallenge glucose values, of whom 26 also had diabetes according to the HbA1c criterion. Of the 480 men who did not have diabetes based on glucose values, 446 also did not have diabetes according to HbA1c criteria; among women, 3 had diabetes based on glucose values, of whom 2 also had diabetes according to the HbA1c criterion. Of the 195 women who did not have diabetes based on glucose values, 185 also did not have diabetes according to HbA1c criteria. Concordance of Glucose and HbA1c criteria was similar in men and women (92% and 94%; p=0.335). Applying glucose criteria as a standard, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the HbA1c criterion for men were 78.8%, 92.9%, 43.3%, and 98.5%, respectively. For women, sensitivity, specificity, PPV and NPV of the HbA1c criterion were 66.7%, 94.9%, 16.7%, and 99.5%, respectively.

Conclusion: We conclude that concordance of glucose and HbA1c criteria among patients with stable CAD is high and is similar in men and women with CAD. However, for both sexes the sensitivity of the HbA1c criterion is poor in this patient population.

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