Glucose levels are associated with cardiovascular disease and death in an international cohort of normal glycaemic and dysglycaemic men and women: the EpiDREAM cohort study

• Published in: European journal of preventive cardiology 2012-08, Vol.19 (4), p.755-764
• Main Authors: Anand, SS, Dagenais, GR, Mohan, V, Diaz, R, Probstfield, J, Freeman, R, Shaw, J, Lanas, F, Avezum, A, Budaj, A, Jung, H, Desai, D, Bosch, J, Yusuf, S, Gerstein, HC
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Asia - epidemiology; Biomarkers - blood; Blood Glucose - analysis; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Europe - epidemiology; Female; Glucose Intolerance - blood; Glucose Intolerance - diagnosis; Glucose Intolerance - epidemiology; Glucose Metabolism Disorders - blood; Glucose Metabolism Disorders - diagnosis; Glucose Metabolism Disorders - epidemiology; Glucose Metabolism Disorders - mortality; Glucose Tolerance Test; Humans; Incidence; Logistic Models; Male; Middle Aged; North America - epidemiology; Odds Ratio; Prognosis; Proportional Hazards Models; Prospective Studies; Risk Assessment; Risk Factors; South America - epidemiology; Time Factors; Up-Regulation
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1177/1741826711409327

Aims: In an international prospective cohort study we assessed the relationship between glucose levels and incident cardiovascular events and death. Methods and results: 18,990 men and women were screened for entry into the DREAM clinical trial from 21 different countries. All had clinical and biochemical information collected at baseline, including an oral glucose tolerance test (OGTT), and were prospectively followed over a median (IQR) of 3.5 (3.0–4.0) years for incident cardiovascular (CV) events including coronary artery disease (CAD), stroke, congestive heart failure (CHF) requiring hospitalization, and death. After OGTT screening, 8000 subjects were classified as normoglycaemic, 8427 had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and 2563 subjects had newly diagnosed type 2 diabetes mellitus (DM). There were incident events in 491 individuals: 282 CAD, 54 strokes, 19 CHF, and 164 died. The annualized CV or death event rate was 0.79/100 person-years in the overall cohort, 0.51/100 person-years in normoglycaemics, 0.92/100 person-years among subjects with IFG and/or IGT at baseline, and 1.27/100 person-years among those with DM (p for trend