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High triglycerides, low HDL cholesterol and a low LDL cholesterol per apolipoprotein B ratio predict incident diabetes in patients with established coronary artery disease

Session Poster session 5

Speaker Christoph Saely

Event : ESC Congress 2015

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease and Comorbidities
  • Session type : Poster Session

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

C.H. Saely1 , P. Rein1 , A. Vonbank1 , D. Zanolin2 , G. Naerr2 , A. Leiherer3 , 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 ), 764

Background and introduction: Patients with type 2 diabetes mellitus (T2DM) exhibit a typical pattern of dyslipidemia with low HDL cholesterol, high triglycerides and a low LDL cholesterol per apolipoprotein B (LDL-C/apoB) ratio reflecting small LDL particles.

Purpose: The purpose of our study was to test the hypothesis that high triglycerides, low HDL cholesterol and a low LDL-C/apoB ratio predict incident T2DM among non-diabetic patients with established coronary artery disease (CAD).

Methods: We enrolled 655 non-diabetic patients with angiographically proven stable CAD. Prospectively, the incidence of T2DM was recorded over a mean follow-up period of 6.1±3.7 years. Diabetes was diagnosed according to ADA criteria.

Results: From our non-diabetic coronary patients, 358 (54.7%) at baseline had normal fasting glucose (NFG) <100 mg/dl, and 297 (45.3%) had impaired fasting glucose (IFG) ≥100 mg/dl. During follow-up, T2DM was newly diagnosed in 17.4% of our patients. Baseline IFG compared to NFG was associated with a strongly increased risk of T2DM (26.6% vs. 9.8%; adjusted OR 3.34 [2.17–5.16]; p<0.001). Low HDL cholesterol, high triglycerides, and a low LDL-C/apoB ratio after multivariate adjustment including fasting glucose significantly predicted incident diabetes in the total study cohort (OR 0.65 [0.49–0.86]; p=0.003, 1.40 [1.13–1.74]; p=0.002 and 0.54 [0.41–0.71]; p<0.001, respectively) and also when we separately analyzed patients with IFG (OR 0.67 [0.46–0.97]; p=0.032, 1.42 [1.03–1.96]; p=0.032 and 0.56 [0.39–0.79]; p=0.001, respectively) and NFG (OR 0.62 [0.40–0.96]; p=0.034, 1.38 [1.03–1.86]; p=0.033 and 0.49 [0.32–0.76]; p=0.001, respectively).

Conclusion: We conclude that among patients with angiographically proven stable CAD the incidence of diabetes is high, particularly among those with IFG. Importantly, high triglycerides, low HDL cholesterol and a low LDL-C/apoB ratio significantly predict incident diabetes independently from baseline glycemia.

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