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Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome

Background:Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS).Methods and Results:We prospectively investigated the clinical impa...

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Published in:	Circulation Journal 2015/09/25, Vol.79(10), pp.2246-2254
Main Authors:	Kataoka, Shunsuke, Gohbara, Masaomi, Iwahashi, Noriaki, Sakamaki, Kentaro, Nakachi, Tatsuya, Akiyama, Eiichi, Maejima, Nobuhiko, Tsukahara, Kengo, Hibi, Kiyoshi, Kosuge, Masami, Ebina, Toshiaki, Umemura, Satoshi, Kimura, Kazuo
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Language:	English
Subjects:	Acute coronary syndrome Acute Coronary Syndrome - blood Acute Coronary Syndrome - physiopathology Aged Blood Glucose - metabolism Female Glycemic variability Humans Male Middle Aged Monitoring, Physiologic Prospective Studies Rapid progression
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container_title	Circulation Journal
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creator	Kataoka, Shunsuke Gohbara, Masaomi Iwahashi, Noriaki Sakamaki, Kentaro Nakachi, Tatsuya Akiyama, Eiichi Maejima, Nobuhiko Tsukahara, Kengo Hibi, Kiyoshi Kosuge, Masami Ebina, Toshiaki Umemura, Satoshi Kimura, Kazuo
description	Background:Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS).Methods and Results:We prospectively investigated the clinical impact of glycemic variability (GV), as determined on continuous glucose monitoring system (CGMS), on RP of non-culprit lesions in 88 patients with ACS. RP was deﬁned as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis
doi_str_mv	10.1253/circj.CJ-15-0496
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RP was deﬁned as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis <50%; development of a new stenosis ≥30% in a previously normal segment; or progression of any stenosis to total occlusion. Patients were classified into 2 groups according to the presence (progressor, n=20) or absence (non-progressor, n=68) of RP. All patients were equipped with a CGMS during the stable phase, and mean amplitude of glycemic excursion (MAGE) was calculated as a marker of GV. Mean MAGE was significantly higher in progressors than in non-progressors (55±19 mg/dl vs. 37±18 mg/dl, P<0.01). On multiple logistic regression analysis, MAGE was an independent predictor of RP (odds ratio, 1.06 per 1 mg/dl; P<0.01).Conclusions:MAGE early after the onset of ACS is a predictor of RP of non-culprit lesions. (Circ J 2015; 79: 2246–2254)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-15-0496</identifier><identifier>PMID: 26227393</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Acute coronary syndrome ; Acute Coronary Syndrome - blood ; Acute Coronary Syndrome - physiopathology ; Aged ; Blood Glucose - metabolism ; Female ; Glycemic variability ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; Prospective Studies ; Rapid progression</subject><ispartof>Circulation Journal, 2015/09/25, Vol.79(10), pp.2246-2254</ispartof><rights>2015 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-168ca3427bc3cabc7a0ed16f65446f8fa47c959ecba1bfbc6573285ea816e9af3</citedby><cites>FETCH-LOGICAL-c495t-168ca3427bc3cabc7a0ed16f65446f8fa47c959ecba1bfbc6573285ea816e9af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26227393$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kataoka, Shunsuke</creatorcontrib><creatorcontrib>Gohbara, Masaomi</creatorcontrib><creatorcontrib>Iwahashi, Noriaki</creatorcontrib><creatorcontrib>Sakamaki, Kentaro</creatorcontrib><creatorcontrib>Nakachi, Tatsuya</creatorcontrib><creatorcontrib>Akiyama, Eiichi</creatorcontrib><creatorcontrib>Maejima, Nobuhiko</creatorcontrib><creatorcontrib>Tsukahara, Kengo</creatorcontrib><creatorcontrib>Hibi, Kiyoshi</creatorcontrib><creatorcontrib>Kosuge, Masami</creatorcontrib><creatorcontrib>Ebina, Toshiaki</creatorcontrib><creatorcontrib>Umemura, Satoshi</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><title>Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS).Methods and Results:We prospectively investigated the clinical impact of glycemic variability (GV), as determined on continuous glucose monitoring system (CGMS), on RP of non-culprit lesions in 88 patients with ACS. RP was deﬁned as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis <50%; development of a new stenosis ≥30% in a previously normal segment; or progression of any stenosis to total occlusion. Patients were classified into 2 groups according to the presence (progressor, n=20) or absence (non-progressor, n=68) of RP. All patients were equipped with a CGMS during the stable phase, and mean amplitude of glycemic excursion (MAGE) was calculated as a marker of GV. Mean MAGE was significantly higher in progressors than in non-progressors (55±19 mg/dl vs. 37±18 mg/dl, P<0.01). On multiple logistic regression analysis, MAGE was an independent predictor of RP (odds ratio, 1.06 per 1 mg/dl; P<0.01).Conclusions:MAGE early after the onset of ACS is a predictor of RP of non-culprit lesions. (Circ J 2015; 79: 2246–2254)</description><subject>Acute coronary syndrome</subject><subject>Acute Coronary Syndrome - blood</subject><subject>Acute Coronary Syndrome - physiopathology</subject><subject>Aged</subject><subject>Blood Glucose - metabolism</subject><subject>Female</subject><subject>Glycemic variability</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Prospective Studies</subject><subject>Rapid progression</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpFkUtv1DAUhSMEog_Ys0Jeskmx4ziOl1UEQ6sBKp5Ly7m5mXqU2IPtLOaX8HfxdIZ245e-c67vPUXxhtErVgn-HmyA7VV3WzJR0lo1z4pzxmtZ1m1Fnz-cm1K1NT8rLmLcUlopKtTL4qxqqkpyxc-Lv6tpDzhbIL9MsKa3k0174h3pvEvWLX6JZDUt4COSz97Z5IN1G_J9HxPO5C7gYCFF8s3s7JCvfhMwRpv1fiRfvCu7ZdoFm8gaD6-RWEfuTLLosui3TffkGpaEuVrwzoR9NnZD8DO-Kl6MZor4-rRfFj8_fvjRfSrXX1c33fW6hFqJVLKmBcPrSvbAwfQgDcWBNWMj6roZ29HUEpRQCL1h_dhDIySvWoGmZQ0qM_LL4t3Rdxf8nwVj0rONgNNkHObeNZNM5mmKtsooPaIQfIwBR507m_OnNaP6EId-iEN3t5oJfYgjS96e3Jd-xuFR8H_-GVgdgW1MZoOPgAnJwoQnR6kOJfL6ZP1E3Jug0fF_Od6k7g</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Kataoka, Shunsuke</creator><creator>Gohbara, Masaomi</creator><creator>Iwahashi, Noriaki</creator><creator>Sakamaki, Kentaro</creator><creator>Nakachi, Tatsuya</creator><creator>Akiyama, Eiichi</creator><creator>Maejima, Nobuhiko</creator><creator>Tsukahara, Kengo</creator><creator>Hibi, Kiyoshi</creator><creator>Kosuge, Masami</creator><creator>Ebina, Toshiaki</creator><creator>Umemura, Satoshi</creator><creator>Kimura, Kazuo</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2015</creationdate><title>Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome</title><author>Kataoka, Shunsuke ; Gohbara, Masaomi ; Iwahashi, Noriaki ; Sakamaki, Kentaro ; Nakachi, Tatsuya ; Akiyama, Eiichi ; Maejima, Nobuhiko ; Tsukahara, Kengo ; Hibi, Kiyoshi ; Kosuge, Masami ; Ebina, Toshiaki ; Umemura, Satoshi ; Kimura, Kazuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-168ca3427bc3cabc7a0ed16f65446f8fa47c959ecba1bfbc6573285ea816e9af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute coronary syndrome</topic><topic>Acute Coronary Syndrome - blood</topic><topic>Acute Coronary Syndrome - physiopathology</topic><topic>Aged</topic><topic>Blood Glucose - metabolism</topic><topic>Female</topic><topic>Glycemic variability</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Prospective Studies</topic><topic>Rapid progression</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kataoka, Shunsuke</creatorcontrib><creatorcontrib>Gohbara, Masaomi</creatorcontrib><creatorcontrib>Iwahashi, Noriaki</creatorcontrib><creatorcontrib>Sakamaki, Kentaro</creatorcontrib><creatorcontrib>Nakachi, Tatsuya</creatorcontrib><creatorcontrib>Akiyama, Eiichi</creatorcontrib><creatorcontrib>Maejima, Nobuhiko</creatorcontrib><creatorcontrib>Tsukahara, Kengo</creatorcontrib><creatorcontrib>Hibi, Kiyoshi</creatorcontrib><creatorcontrib>Kosuge, Masami</creatorcontrib><creatorcontrib>Ebina, Toshiaki</creatorcontrib><creatorcontrib>Umemura, Satoshi</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kataoka, Shunsuke</au><au>Gohbara, Masaomi</au><au>Iwahashi, Noriaki</au><au>Sakamaki, Kentaro</au><au>Nakachi, Tatsuya</au><au>Akiyama, Eiichi</au><au>Maejima, Nobuhiko</au><au>Tsukahara, Kengo</au><au>Hibi, Kiyoshi</au><au>Kosuge, Masami</au><au>Ebina, Toshiaki</au><au>Umemura, Satoshi</au><au>Kimura, Kazuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2015</date><risdate>2015</risdate><volume>79</volume><issue>10</issue><spage>2246</spage><epage>2254</epage><pages>2246-2254</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><abstract>Background:Although rapid progression (RP) of coronary artery disease (CAD) has been shown to be a powerful predictor of cardiovascular events, predictors of RP are not fully understood in patients with acute coronary syndrome (ACS).Methods and Results:We prospectively investigated the clinical impact of glycemic variability (GV), as determined on continuous glucose monitoring system (CGMS), on RP of non-culprit lesions in 88 patients with ACS. RP was deﬁned as ≥10% diameter reduction in a pre-existing stenosis ≥50%; ≥30% diameter reduction in a stenosis <50%; development of a new stenosis ≥30% in a previously normal segment; or progression of any stenosis to total occlusion. Patients were classified into 2 groups according to the presence (progressor, n=20) or absence (non-progressor, n=68) of RP. All patients were equipped with a CGMS during the stable phase, and mean amplitude of glycemic excursion (MAGE) was calculated as a marker of GV. Mean MAGE was significantly higher in progressors than in non-progressors (55±19 mg/dl vs. 37±18 mg/dl, P<0.01). On multiple logistic regression analysis, MAGE was an independent predictor of RP (odds ratio, 1.06 per 1 mg/dl; P<0.01).Conclusions:MAGE early after the onset of ACS is a predictor of RP of non-culprit lesions. 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subjects	Acute coronary syndrome Acute Coronary Syndrome - blood Acute Coronary Syndrome - physiopathology Aged Blood Glucose - metabolism Female Glycemic variability Humans Male Middle Aged Monitoring, Physiologic Prospective Studies Rapid progression
title	Glycemic Variability on Continuous Glucose Monitoring System Predicts Rapid Progression of Non-Culprit Lesions in Patients With Acute Coronary Syndrome
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