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
Authors: Giulia Ferrannini, Dirk De Bacquer, Guy De Backer, Kornelia Kotseva, Linda Mellbin, David Wood, Lars Rydén, Christopher P. Gale, Branko Beleslin, Andrzej Budaj, Ovidiu Chioncel, Nikolaos Dagres, Nicolas Danchin, David Erlinge, Jonathan Emberson, Michael Glikson, Alastair Gray, Meral Kayikcioglu, Aldo P. Maggioni, Klaudia Vivien Nagy, Aleksandr Nedoshivin, Anna-Sonia Petronio, Jolien Roos-Hesselink, Lars Wallentin, Uwe Zeymer, K. Kotseva, G. De Backer, Ana Abreu, Carlos Aguiar, Jolita Badariene, Jan Bruthans, Almudena Castro Conde, Renata Cifkova, Jim Crowley, Kairat Davletov, D. De Bacquer, Delphine De Smedt, Johan De Sutter, Jaap W. Deckers, Mirza Dilic, Maryna Dolzhenko, H. Druais, Vilnis Dzerve, Andrejs Erglis, Zlatko Fras, Dan Gaita, Nina Gotcheva, D.E. Grobbee, V. Gyberg, Hosam Hasan Ali, Peter Heuschmann, A.W. Hoes, Piotr Jankowski, Nebojsa Lalic, Seppo Lehto, Dragan Lovic, Silvia Mancas, P. Marques-Vidal, L. Mellbin, Davor Miličić, Erkin Mirrakhimov, Rafael Oganov, Nana Pogosova, Željko Reiner, Lars Rydén, M. Stagmo, Stefan Störk, J. Sundvall, Lâle Tokgözoğlu, Costas Tsioufis, Duško Vulic, D. Wood, Arno Hoes, Catriona Jennings, A. Adamska, S. Adamska, L.J. Tuomilehto, O. Schnell, L. Raman, A.M. Willems, M. De Pauw, P. Vervaet, Jessa Ziekenhuis, J. Bollen, E. Dekimpe, N. Mommen, G. Van Genechten, P. Dendale, A. Bouvier, P. Chenu, D. Huyberechts, A. Persu, A. Begic, A. Durak Nalbantic, A. Dzubur, N. Hadzibegic, A. Iglica, S. Kapidjic, A. Osmanagic Bico, N. Resic, N. Sabanovic Bajramovic, F. Zvizdic, T. Kovacevic-Preradovic, S. Popovic-Pejicic, D. Djekic, T. Gnjatic, T. Knezevic, L. Kos, S. Popovic-Pejicic, B. Stanetic, G. Topic, Borislav Georgiev, A. Terziev, G. Vladimirov, A. Angelov, B. Kanazirev, S. Nikolaeva, D. Tonkova, M. Vetkova, A. Bosnic, M. Dubravcic, M. Glavina, M. Mance, S. Pavasovic, J. Samardzic, T. Batinic, K. Crljenko, D. Delic-Brkljacic, K. Dula, K. Golubic, I. Klobucar, K. Kordic, N. Kos, M. Nedic, D. Olujic, V. Sedinic, T. Blazevic, A. Pasalic, M. Percic, J. Sikic, K. Hašplová, P. Šulc, P. Wohlfahrt, O. Mayer, M. Cvíčela, J. Filipovský, J. Gelžinský, M. Hronová, S. Bakery, E. Mosad, H.B. Hamed, A. Ibrahim, M.A. Elsharef, E.F. Kholef, A. Shehata, M. Youssef, E. Elhefny, H. Farid, T.M. Moustafa, M.S. Sobieh, H. Kabil, A. Abdelmordy, E. Kiljander, P. Kiljander, H. Koukkunen, J. Mustonen, C. Cremer, S. Frantz, A. Haupt, U. Hofmann, K. Ludwig, H. Melnyk, M. Noutsias, W. Karmann, R. Prondzinsky, C. Herdeg, T. Hövelborn, A. Daaboul, T. Geisler, T. Keller, D. Sauerbrunn, M. Walz-Ayed, G. Ertl, R. Leyh, T. Ehlert, B. Klocke, J. Krapp, T. Ludwig, J. Käs, C. Starke, K. Ungethüm, M. Wagner, S. Wiedmann, P. Tolis, G. Vogiatzi, E. Sanidas, K. Tsakalis, J. Kanakakis, A. Koutsoukis, K. Vasileiadis, J. Zarifis, C. Karvounis, I. Gibson, A. Houlihan, C. Kelly, M. O’Donnell, M. Bennati, F. Cosmi, B. Mariottoni, M. Morganti, A. Cherubini, A. Di Lenarda, D. Radini, F. Ramani, M.G. Francese, M.M. Gulizia, D. Pericone, K. Aigerim, Z. Bekbolat, B. Amirov, B. Assembekov, E. Chernokurova, F. Ibragimova, A. Kodasbayev, A. Markova, A. Asanbaev, U. Toktomamatov, M. Tursunbaev, U. Zakirov, S. Abilova, R. Arapova, E. Bektasheva, J. Esenbekova, K. Neronova, K. Baigaziev, G. Baitova, T. Zheenbekov, T. Andrejeva, I. Bajare, G. Kucika, A. Labuce, L. Putane, M. Stabulniece, E. Klavins, I. Sime, L. Gedvilaite, D. Pečiuraite, V. Sileikienė, E. Skiauteryte, S. Solovjova, R. Sidabraite, K. Briedis, I. Ceponiene, M. Jurenas, J. Kersulis, G. Martinkute, A. Vaitiekiene, K. Vasiljevaite, R. Veisaite, J. Plisienė, V. Šiurkaitė, Ž. Vaičiulis, D. Czarnecka, P. Kozieł, P. Podolec, J. Nessler, P. Gomuła, E. Mirek-Bryniarska, P. Bogacki, A. Wiśniewski, A. Pająk, R. Wolfshaut-Wolak, J. Bućko, K. Kamiński, M. Łapińska, M. Paniczko, A. Raczkowski, E. Sawicka, Z. Stachurska, M. Szpakowicz, W. Musiał, S. Dobrzycki, J. Bychowski, D.A. Kosior, A. Krzykwa, M. Setny, A. Rak, Z. Gąsior, M. Haberka, K. Szostak-Janiak, M. Finik, J. Liszka, A. Botelho, M. Cachulo, J. Sousa, A. Pais, A. Durazzo, D. Matos, R. Gouveia, G. Rodrigues, C. Strong, R. Guerreiro, J. Aguiar, M. Cruz, P. Daniel, L. Morais, R. Moreira, S. Rosa, I. Rodrigues, M. Selas, A. Apostu, O. Cosor, L. Gaita, L. Giurgiu, C. Hudrea, D. Maximov, B. Moldovan, S. Mosteoru, R. Pleava, M. Ionescu, I. Parepa, A. Arutyunov, A. Ausheva, S. Isakova, A. Karpova, A. Salbieva, O. Sokolova, A. Vasilevsky, Y. Pozdnyakov, O. Antropova, L. Borisova, I. Osipova, M. Aleksic, B. Crnokrak, J. Djokic, S. Hinic, T. Vukasin, M. Zdravkovic, A. Jotic, K. Lalic, L. Lukic, T. Milicic, M. Macesic, J. StanarcicGajovic, M. Stoiljkovic, D. Djordjevic, S. Kostic, I. Tasic, A. Vukovic, B. Jug, A. Juhant, A. Krt, U. Kugonjič, D. Chipayo Gonzales, J.J. Gómez Barrado, Z. Kounka, G. Marcos Gómez, M.V. Mogollón Jiménez, C. Ortiz Cortés, P. Perez Espejo, Y. Porras Ramos, R. Colman, J. Delgado, E. Otero, A. Pérez, M.R. Fernández-Olmo, J. Torres-LLergo, C. Vasco, E. Barreñada, J. Botas, R. Campuzano, Y. González, M. Rodrigo, C. de Pablo, E. Velasco, S. Hernández, C. Lozano, P. González, R. Dalmau, D. Hernández, F.J. Irazusta, A. Vélez, C. Vindel, J.J. Gómez-Doblas, V. García Ruíz, L. Gómez, M. Gómez García, M. Jiménez-Navarro, A. Molina Ramos, D. Marzal, G. Martínez, R. Lavado, A. Vidal, V. Boström-Nilsson, B. Kjellström, B. Shahim, S. Smetana, O. Hansen, E. Stensgaard-Nake, A.J. Klijn, T.J.P. Mangus, R J.G. Peters, W. Scholte op Reimer, M. Snaterse, S. Aydoğdu, Ç. Erol, S. Oztürk, C. Tulunay Kaya, Y. Ahmetoğlu, O. Ergene, B. Akdeniz, D. Çırgamış, S. Akkoyun H. Kültürsay, M. Kayıkçıoğlu, A.B. Çatakoğlu, A. Çengel, A. Koçak, M.A. Ağırbaşlı, G. Açıksarı, M.E. Çekin, E.B. Kaya, D. Koçyiğit, Z. Öngen, E. Özmen, V. Sansoy, A. Kaya, V. Oktay, A. Temizhan, S. Ünal, İ. Yakut, A.K. Kalkan, E. Bozkurt, H.A. Kasapkara, C. Faradzh, L. Hrubyak, L. Konoplianyk, N. Kozhuharyova, L. Lobach, V. Nesukai, O. Nudchenko, T. Simagina, L. Yakovenko, V. Azarenko, V. Potabashny, A. Bazylevych, M. Bazylevych, K. Kaminska, L. Panchenko, O. Shershnyova, T. Ovrakh, S. Serik, T. Kolesnik, H. Kosova, A. Hoye P. Atkin, D. Fellowes, S. Lindsay, C. Atkinson, C. Kranilla, M. Vinod, H. Abbass, N. Rhoualmi, Y. Beerachee, C. Bennett, M. Broome, A. Bwalya, Lindsay Caygill, L. Dinning, A. Gillespie, R. Goodfellow, J. Guy, T. Idress, C. Mills, C. Morgan, N. Oustance, N. Singh, M. Yare, J.M. Jagoda, H. Bowyer, V. Christenssen, A. Groves, A. Jan, A. Riaz, M. Gill, T.A. Sewell, D. Gorog, M. Baker, P. De Sousa, T. Mazenenga, J. Porter, F. Haines, T. Peachey, J. Taaffe, K. Wells, D.P. Ripley, H. Forward, H. McKie, S.L. Pick, H.E. Thomas, P.D. Batin, D. Exley, T. Rank, J. Wright, A. Kardos, S.-B. Sutherland, L. Wren, P. Leeson, D. Barker, B. Moreby, J. Sawyer, J. Stirrup, M. Brunton, A. Brodison, J. Craig, S. Peters, R. Kaprielian, A. Bucaj, K. Mahay, M. Oblak, C. Gale, M. Pye, Y. McGill, H. Redfearn, M. Fearnley
Journal: Diabetes Care (2020)

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.