Should oral glucose tolerance test be a routine examination after a myocardial infarction?

Background: Diabetes mellitus (DM) and impaired glucose tolerance (IGT) are important cardiovascular risk factors. The objective of this study was to assess the prevalence of DM and IGT in patients discharged from the CCU without known DM after a myocardial infarction. Methods: One hundred and ten patients, men and women aged 31-80 years with a myocardial infarction 1-12 months before inclusion were examined with oral glucose tolerance test. Patients with known DM were excluded. A standard oral glucose test (OGTT) with 75 g of glucose was performed. Results: IGT was observed in 29 (26%) patients and DM in 13 (12%) patients in the OGTT. If only fasting plasma glucose (FPG) was used alone five (38.5%) patients with diabetes subjects and three (10.3%) with IGT were identified. Thus, a FPG test alone identified only 19.0% of the patients with pathological OGTT. The prevalence of DM and IGT in patients discharged from the CCU after a myocardial infarction without known DM diagnosis was high (38%). A fasting glucose alone failed to identify more than 80% of the patients with pathological glucose tolerance in this study. Conclusion: Since pathological glucose tolerance is an important cardiovascular risk factor, oral glucose tolerance test should be considered as a routine test after a myocardial infarction in subjects without known DM. (C) 2003 Elsevier Ireland Ltd. All rights reserved.