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The Euro Heart Survey – Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease

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Abstract

Aim

Diabetes mellitus is associated with a poor prognosis due to a high rate of coronary artery disease. It was the aim of this survey to assess the prevalence of an impaired glucose tolerance and manifest diabetes mellitus in patients with coronary artery disease (CAD).

Methods

We analyzed data of all German centers participating in the Euro Heart Survey on diabetes and the heart, an European-wide multicenter prospective observational study. Participating centers were asked to recruit patients >18 years with a diagnosis of CAD.

Results

In Germany, 261 patients with a diagnosis of CAD were enrolled in five participating centers. Patients were divided into an acutely (22,4%; n = 57) or electively admitted (77,6%; n = 198) group. There were 34% (n = 89) of patients with already known diabetes. In 36% (n = 22 of 56) of the patients without previously known diabetes, an oral glucose tolerance test (OGTT) was performed (3%, n = 5 in the acute and 33%, n = 51 in the elective group). As a result, 39% (n = 22 of 56) of these patients had an impaired glucose tolerance (acute group: 0%, n = 0 of 5; elective group: 43%, n = 22 of 51) and in 13% (n = 7 of 56) diabetes mellitus was diagnosed (acute group: 40%, n = 2 of 5; elective group: 10%, n = 5 of 51). Furthermore, on admission 86% of women and 94% of men reported to exercise less than three times per week and thus less than recommended in current guidelines.

Conclusion

More than one third of the patients with CAD who underwent an OGTT had an impaired glucose tolerance. Implementation of this simple, effective and inexpensive test into clinical routine of patients with CAD would help diagnose diabetes mellitus and thus grant these high risk patients access to an optimal medical, interventional and surgical therapy. Furthermore, patients ought to be encouraged to include exercise training into their daily routine.

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References

  1. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15(7):539–553

    Article  PubMed  CAS  Google Scholar 

  2. Bartnik M, Malmberg K, Norhammar A, Tenerz A, Ohrvik J, Ryden L (2004) Newly detected abnormal glucose tolerance: an important predictor of long-termoutcome after myocardial infarction. Eur Heart J 25(22):1990–1997

    Article  PubMed  CAS  Google Scholar 

  3. Bartnik M, Ryden L, Ferrari R, Malmberg K, Pyorala K, Simoons M, Standl E, Soler Soler J, Ohrvik J, Euro Heart Survey Investigators (2004) The prevalence of abnormal glucose regulation in patients with coronary artery disease across Europe. The Euro Heart Survey on diabetes and the heart. Eur Heart J 25:1880–1890

    Article  PubMed  CAS  Google Scholar 

  4. Bischoff B, Silber S, Richartz BM, Pieper L, Klotsche J, Wittchen HU, DETECT Study-Group (2006) Inadequate medical treatment of patients with coronary artery disease by primary care physicians in Germany. Clin Res Cardiol 95(8):405–412

    Article  PubMed  CAS  Google Scholar 

  5. Gohlke H, Kübler W, Mathes P, Meinertz T, Schuler G, Gysan DB, Sauer G, Germans Society of Cardiologiy (2005) Position paper on the primary prevention of cardiovascular diseases. Z Kardiol 94(Suppl 3):III/113–III/115

    Google Scholar 

  6. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M (1998) Mortality from coronary heart disease in subjects with type 2 diabetes and innondiabetic subjects with and without prior myocardial infarction. N Engl J Med 339(4):229–234

    Article  PubMed  CAS  Google Scholar 

  7. Lankisch M, Futh R, Schotes D, Rose B, Lapp H, Rathmann W, Haastert B, Gulker H, Scherbaum WA, Martin S (2006) High prevalence of undiagnosed impaired glucose regulation and diabetes mellitus in patients scheduled for an elective coronary angiography. Clin Res Cardiol 95(2):80–87

    Article  PubMed  CAS  Google Scholar 

  8. Leschke M, Schwenk B, Bollinger C, Faehling M (2006) Impaired glucose metabolism in patients with ischaemic heart disease. Clin Res Cardiol 95(Suppl 1):i98–i102

    Article  PubMed  Google Scholar 

  9. Malmberg K, Ryden L, Efendic S, Herlitz J, Nicol P, Waldenstrom A, Wedel H, Welin L (1995) Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol 26(1):57–65

    Article  PubMed  CAS  Google Scholar 

  10. Niebauer J, Sixt S, Zhang F, Yu J, Sick P, Thiele H, Lauer B, Schuler G (2004) Impact of diabetes mellitus type 2 on in-hospital outcome after cardiac catheterisation in a large cohort of octogenarians. Int J Cardiol 96:441–446

    Article  PubMed  Google Scholar 

  11. Niebauer J (2006) Evidenz-basierte Anwendung und Leitlinien-gemäβe Dosierung des Therapeutikums Sport: Körperliches Training bei Diabetes mellitus Typ 2. Univers Inn Med 6:30

    Google Scholar 

  12. Niebauer J, Weitgasser R (2007) Leitlinie Diabetes mellitus Typ 2—Lebensstil: Diagnostik und Therapie. Wien Klein Wochenschr 119/15–16(Suppl 2):10–11

    Google Scholar 

  13. No authors listed (2000) Myocardial infarction redefined – a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 21(18):1502–1513

    Google Scholar 

  14. Norhammar A, Malmberg K, Diderholm E, Lagerqvist B, Lindahl B, Ryden L, Wallentin L (2004) Diabetes mellitus: the major risk factor in unstable coronary artery disease even after consideration of the extent of coronary artery disease and benefits of revascularization. J Am Coll Cardiol 43(4):585–591

    Article  PubMed  Google Scholar 

  15. Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendic S, Ryden L, Malmberg K (2002) Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 359(9324):2140–2144

    Article  PubMed  CAS  Google Scholar 

  16. Ryden L, Standl E, Bartnik M, Van den Berghe G, Betteridge J, de Boer MJ, Cosentino F, Jonsson B, Laakso M, Malmberg K, Priori S, Ostergren J, Tuomilehto J, Thrainsdottir I, Vanhorebeek I, Stramba-Badiale M, Lindgren P, Qiao Q, Priori SG, Blanc JJ, Budaj A, Camm J, Dean V, Deckers J, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo J, Zamorano JL, Deckers JW, Bertrand M, Charbonnel B, Erdmann E, Ferrannini E, Flyvbjerg A, Gohlke H, Juanatey JR, Graham I, Monteiro PF, Parhofer K, Pyorala K, Raz I, Schernthaner G, Volpe M, Wood D, Task Force on Diabetes, Cardiovascular Diseases of the European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD) (2007) Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The task force on diabetes and cardiovascular diseases of the European society of cardiology (ESC) and of the European association for the study of diabetes (EASD). Eur Heart J 28(1):88–136

    Article  PubMed  CAS  Google Scholar 

  17. Schächinger V, Britten MB, Zeiher AM (2006) Diabetes mellitus and coronary artery disease-a high risk combination. Clin Res Cardiol 95(Suppl 1):i18–i26

    Article  PubMed  Google Scholar 

  18. Schnell O, Schafer O, Kleybrink S, Doering W, Standl E, Otter W (2004) Intensification of therapeutic approaches reduces mortality in diabetic patients with acute myocardial infarction: the Munich registry. Diabetes Care 27(2):455–460

    Article  PubMed  Google Scholar 

  19. Schönauer M, Kautz C, Thomas A, Niebauer J (2007) Überblick: kardiale autonome diabetische neuropathie. Diabetologie 2:175–182

    Article  Google Scholar 

  20. Sixt S, Schuler G, Niebauer J (2004) Akutelle Therapieoptionen bei diabetes mellitus Typ 2 und koronarer Herzkrankheit: Intensivierte Sekundärprävention vs. perkutane oder chirurgische Revaskularisierung. Dtsch Med Wochenschr 129:1385–1389

    Article  PubMed  CAS  Google Scholar 

  21. Taubert G, Winkelmann BR, Schleiffer T, Marz W, Winkler R, Gok R, Klein B, Schneider S, Boehm BO (2003) Prevalence, predictors, and consequences of unrecognized diabetes mellitus in 3266 patients scheduled for coronary angiography. Am Heart J 145(2):285–291

    Article  PubMed  Google Scholar 

  22. Tschöpe D (2006) Diabetics in secondary prevention. Clin Res Cardiol 95(Suppl 6):VI23–VI27

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Kardiologie, Herzzentrum Leipzig, Leipzig, Germany

    K. Drechsler & S. Fikenzer

  2. Abteilung für Kardiologie, Robert Bosch Krankenhaus Stuttgart, Stuttgart, Germany

    U. Sechtem

  3. Elisabeth-Krankenhaus Essen, Essen, Germany

    E. Blank

  4. Herzzentrum Münster, Münster, Germany

    G. Breithardt

  5. Medizinische Klinik B des Klinikums der Stadt Ludwigshafen am Rhein, Ludwigshafen am Rhein, Germany

    U. Zeymer

  6. Institut für Sportmedizin, Paracelsus Medizinische Privatuniversität Salzburg, Salzburg, Austria

    J. Niebauer

  7. Institut für Sportmedizin des Landes Salzburg, Universitätsinstitut für präventive und rehabilitative Sportmedizin der, Paracelsus Medizinischen Privatuniversität Salzburg, Lindhofstr. 20, 5020, Salzburg, Austria

    J. Niebauer

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  1. K. Drechsler
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  2. S. Fikenzer
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  7. J. Niebauer
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Correspondence to J. Niebauer.

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Drechsler, K., Fikenzer, S., Sechtem, U. et al. The Euro Heart Survey – Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease. Clin Res Cardiol 97, 364–370 (2008). https://doi.org/10.1007/s00392-008-0643-z

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  • DOI: https://doi.org/10.1007/s00392-008-0643-z

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