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Cited by 75Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementDiabetes Management and Research

Screening for glucose perturbations and risk factor management in dysglycemic patients with coronary artery disease—a persistent challenge in need of substantial improvement: a report from ESC EORP EUROASPIRE V

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Ferrannini, Giulia, De Bacquer, Dirk, De Backer, Guy, Kotseva, Kornelia, Mellbin, Linda, Wood, David, Rydén, Lars, EUROASPIRE V collaborators +516 more·2020·Diabetes Care
DOI 10.2337/dc19-2165
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Abstract

OBJECTIVE: Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects. RESEARCH DESIGN AND METHODS: The European Society of Cardiology’s European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016–2017) included 8,261 CAD patients, aged 18–80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated. RESULTS: A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium–glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small. CONCLUSIONS: Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.

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Ferrannini, G., De Bacquer, D., De Backer, G., Kotseva, K., Mellbin, L., Wood, D., Rydén, L., collaborators, E. V., Gale, C. P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A. P., Nagy, K. V., Nedoshivin, A., Petronio, A.-S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Kotseva, K., De Backer, G., Abreu, A., Aguiar, C., Badariene, J., Bruthans, J., Castro Conde, A., Cifkova, R., Crowley, J., Davletov, K., De Bacquer, D., De Smedt, D., De Sutter, J., Deckers, J. W., Dilic, M., Dolzhenko, M., Druais, H., Dzerve, V., Erglis, A., Fras, Z., Gaita, D., Gotcheva, N., Grobbee, D. E., Gyberg, V., Hasan Ali, H., Heuschmann, P., Hoes, A. W., Jankowski, P., Lalic, N., Lehto, S., Lovic, D., Mancas, S., Marques-Vidal, P., Mellbin, L., Miličić, D., Mirrakhimov, E., Oganov, R., Pogosova, N., Reiner, Ž., Rydén, L., Stagmo, M., Störk, S., Sundvall, J., Tokgözoğlu, L., Tsioufis, C., Vulic, D., Wood, D., Hoes, A., Jennings, C., Adamska, A., Adamska, S., Tuomilehto, L. J., Schnell, O., Raman, L., Willems, A. M., De Pauw, M., Vervaet, P., Ziekenhuis, J., Bollen, J., Dekimpe, E., Mommen, N., Van Genechten, G., Dendale, P., Bouvier, A., Chenu, P., Huyberechts, D., Persu, A., Begic, A., Durak Nalbantic, A., Dzubur, A., Hadzibegic, N., Iglica, A., Kapidjic, S., Osmanagic Bico, A., Resic, N., Sabanovic Bajramovic, N., Zvizdic, F., Kovacevic-Preradovic, T., Popovic-Pejicic, S., Djekic, D., Gnjatic, T., Knezevic, T., Kos, L., Popovic-Pejicic, S., Stanetic, B., Topic, G., Georgiev, B., Terziev, A., Vladimirov, G., Angelov, A., Kanazirev, B., Nikolaeva, S., Tonkova, D., Vetkova, M., Bosnic, A., Dubravcic, M., Glavina, M., Mance, M., Pavasovic, S., Samardzic, J., Batinic, T., Crljenko, K., Delic-Brkljacic, D., Dula, K., Golubic, K., Klobucar, I., Kordic, K., Kos, N., Nedic, M., Olujic, D., Sedinic, V., Blazevic, T., Pasalic, A., Percic, M., Sikic, J., Hašplová, K., Šulc, P., Wohlfahrt, P., Mayer, O., Cvíčela, M., Filipovský, J., Gelžinský, J., Hronová, M., Bakery, S., Mosad, E., Hamed, H. B., Ibrahim, A., Elsharef, M. A., Kholef, E. F., Shehata, A., Youssef, M., Elhefny, E., Farid, H., Moustafa, T. M., Sobieh, M. S., Kabil, H., Abdelmordy, A., Kiljander, E., Kiljander, P., Koukkunen, H., Mustonen, J., Cremer, C., Frantz, S., Haupt, A., Hofmann, U., Ludwig, K., Melnyk, H., Noutsias, M., Karmann, W., Prondzinsky, R., Herdeg, C., Hövelborn, T., Daaboul, A., Geisler, T., Keller, T., Sauerbrunn, D., Walz-Ayed, M., Ertl, G., Leyh, R., Ehlert, T., Klocke, B., Krapp, J., Ludwig, T., Käs, J., Starke, C., Ungethüm, K., Wagner, M., Wiedmann, S., Tolis, P., Vogiatzi, G., Sanidas, E., Tsakalis, K., Kanakakis, J., Koutsoukis, A., Vasileiadis, K., Zarifis, J., Karvounis, C., Gibson, I., Houlihan, A., Kelly, C., O’Donnell, M., Bennati, M., Cosmi, F., Mariottoni, B., Morganti, M., Cherubini, A., Di Lenarda, A., Radini, D., Ramani, F., Francese, M. G., Gulizia, M. M., Pericone, D., Aigerim, K., Bekbolat, Z., Amirov, B., Assembekov, B., Chernokurova, E., Ibragimova, F., Kodasbayev, A., Markova, A., Asanbaev, A., Toktomamatov, U., Tursunbaev, M., Zakirov, U., Abilova, S., Arapova, R., Bektasheva, E., Esenbekova, J., Neronova, K., Baigaziev, K., Baitova, G., Zheenbekov, T., Andrejeva, T., Bajare, I., Kucika, G., Labuce, A., Putane, L., Stabulniece, M., Klavins, E., Sime, I., Gedvilaite, L., Pečiuraite, D., Sileikienė, V., Skiauteryte, E., Solovjova, S., Sidabraite, R., Briedis, K., Ceponiene, I., Jurenas, M., Kersulis, J., Martinkute, G., Vaitiekiene, A., Vasiljevaite, K., Veisaite, R., Plisienė, J., Šiurkaitė, V., Vaičiulis, Ž., Czarnecka, D., Kozieł, P., Podolec, P., Nessler, J., Gomuła, P., Mirek-Bryniarska, E., Bogacki, P., Wiśniewski, A., Pająk, A., Wolfshaut-Wolak, R., Bućko, J., Kamiński, K., Łapińska, M., Paniczko, M., Raczkowski, A., Sawicka, E., Stachurska, Z., Szpakowicz, M., Musiał, W., Dobrzycki, S., Bychowski, J., Kosior, D. A., Krzykwa, A., Setny, M., Rak, A., Gąsior, Z., Haberka, M., Szostak-Janiak, K., Finik, M., Liszka, J., Botelho, A., Cachulo, M., Sousa, J., Pais, A., Durazzo, A., Matos, D., Gouveia, R., Rodrigues, G., Strong, C., Guerreiro, R., Aguiar, J., Cruz, M., Daniel, P., Morais, L., Moreira, R., Rosa, S., Rodrigues, I., Selas, M., Apostu, A., Cosor, O., Gaita, L., Giurgiu, L., Hudrea, C., Maximov, D., Moldovan, B., Mosteoru, S., Pleava, R., Ionescu, M., Parepa, I., Arutyunov, A., Ausheva, A., Isakova, S., Karpova, A., Salbieva, A., Sokolova, O., Vasilevsky, A., Pozdnyakov, Y., Antropova, O., Borisova, L., Osipova, I., Aleksic, M., Crnokrak, B., Djokic, J., Hinic, S., Vukasin, T., Zdravkovic, M., Jotic, A., Lalic, K., Lukic, L., Milicic, T., Macesic, M., StanarcicGajovic, J., Stoiljkovic, M., Djordjevic, D., Kostic, S., Tasic, I., Vukovic, A., Jug, B., Juhant, A., Krt, A., Kugonjič, U., Chipayo Gonzales, D., Gómez Barrado, J. J., Kounka, Z., Marcos Gómez, G., Mogollón Jiménez, M. V., Ortiz Cortés, C., Perez Espejo, P., Porras Ramos, Y., Colman, R., Delgado, J., Otero, E., Pérez, A., Fernández-Olmo, M. R., Torres-LLergo, J., Vasco, C., Barreñada, E., Botas, J., Campuzano, R., González, Y., Rodrigo, M., de Pablo, C., Velasco, E., Hernández, S., Lozano, C., González, P., Dalmau, R., Hernández, D., Irazusta, F. J., Vélez, A., Vindel, C., Gómez-Doblas, J. J., García Ruíz, V., Gómez, L., Gómez García, M., Jiménez-Navarro, M., Molina Ramos, A., Marzal, D., Martínez, G., Lavado, R., Vidal, A., Boström-Nilsson, V., Kjellström, B., Shahim, B., Smetana, S., Hansen, O., Stensgaard-Nake, E., Klijn, A. J., Mangus, T. J. P., Peters, R. J. G., Scholte op Reimer, W., Snaterse, M., Aydoğdu, S., Erol, Ç., Oztürk, S., Tulunay Kaya, C., Ahmetoğlu, Y., Ergene, O., Akdeniz, B., Çırgamış, D., Akkoyun H. Kültürsay, S., Kayıkçıoğlu, M., Çatakoğlu, A. B., Çengel, A., Koçak, A., Ağırbaşlı, M. A., Açıksarı, G., Çekin, M. E., Kaya, E. B., Koçyiğit, D., Öngen, Z., Özmen, E., Sansoy, V., Kaya, A., Oktay, V., Temizhan, A., Ünal, S., Yakut, İ., Kalkan, A. K., Bozkurt, E., Kasapkara, H. A., Faradzh, C., Hrubyak, L., Konoplianyk, L., Kozhuharyova, N., Lobach, L., Nesukai, V., Nudchenko, O., Simagina, T., Yakovenko, L., Azarenko, V., Potabashny, V., Bazylevych, A., Bazylevych, M., Kaminska, K., Panchenko, L., Shershnyova, O., Ovrakh, T., Serik, S., Kolesnik, T., Kosova, H., Hoye P. Atkin, A., Fellowes, D., Lindsay, S., Atkinson, C., Kranilla, C., Vinod, M., Abbass, H., Rhoualmi, N., Beerachee, Y., Bennett, C., Broome, M., Bwalya, A., Caygill, L., Dinning, L., Gillespie, A., Goodfellow, R., Guy, J., Idress, T., Mills, C., Morgan, C., Oustance, N., Singh, N., Yare, M., Jagoda, J. M., Bowyer, H., Christenssen, V., Groves, A., Jan, A., Riaz, A., Gill, M., Sewell, T. A., Gorog, D., Baker, M., De Sousa, P., Mazenenga, T., Porter, J., Haines, F., Peachey, T., Taaffe, J., Wells, K., Ripley, D. P., Forward, H., McKie, H., Pick, S. L., Thomas, H. E., Batin, P. D., Exley, D., Rank, T., Wright, J., Kardos, A., Sutherland, S.-B., Wren, L., Leeson, P., Barker, D., Moreby, B., Sawyer, J., Stirrup, J., Brunton, M., Brodison, A., Craig, J., Peters, S., Kaprielian, R., Bucaj, A., Mahay, K., Oblak, M., Gale, C., Pye, M., McGill, Y., Redfearn, H., & Fearnley, M.
Affiliations
  • Karolinska University Hospital (SE)
  • European Society of Cardiology, Sophia Antipolis, France
  • Cardiology Unit, Department of Medicine K2, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
  • Ollscoil na Gaillimhe – University of Galway (IE)
  • European Society of Cardiology (FR)
Corresponding author
Reiner, Željko
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2020-02-20
Volume
43
Issue
4
Pages
726-733
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc19-2165
OpenAlex
W3007693026
Cited by
75
References
40
Citations by year
2026: 2 · 2025: 7 · 2024: 13 · 2023: 9 · 2022: 17 · 2021: 21 · 2020: 6
FWCI
9.99
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor, 29 d)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • IRIS (submittedVersion)
  • Lithuanian University of Health Sciences (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
  • STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
Funders
  • Amgen
  • Eli Lilly and Company
  • Pfizer
  • Sanofi
  • British Heart Foundation (FS/11/65/28865)
  • European Society of Cardiology
  • Novo Nordisk
  • Daiichi Sankyo Europe
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
dysglycemia, coronary artery disease, impaired glucose tolerance, type 2 diabetes, glycemic screening, oral glucose tolerance test, HbA1c, risk factor control, secondary prevention, SGLT2 inhibitors, GLP-1 receptor agonists, cardiovascular events
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Blood Glucose, Coronary Artery Disease, Diabetes Mellitus, Type 2, Europe, Female, Glucose Tolerance Test, Health Services Needs and Demand, Humans, Male, Mass Screening, Middle Aged, Primary Prevention, Risk Factors, Program Evaluation, Glucose Intolerance, Glucose Metabolism Disorders, Young Adult, Quality Improvement

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