OBJECTIVE Three tests are recommended for identifying dysglycemia: fasting glucose (FPG), 2-h postload glucose (2h-PG) from an oral glucose tolerance test (OGTT), and glycated hemoglobin A_1c (HbA_1c). This study explored the prognostic value of these screening tests in patients with coronary artery disease (CAD).

RESEARCH DESIGN AND METHODS FPG, 2h-PG, and HbA_1c were used to screen 4,004 CAD patients without a history of diabetes (age 18–80 years) for dysglycemia. The prognostic value of these tests was studied after 2 years of follow-up. The primary end point included cardiovascular mortality, nonfatal myocardial infarction, stroke, or hospitalization for heart failure and a secondary end point of incident diabetes.

RESULTS Complete information including all three glycemic parameters was available in 3,775 patients (94.3%), of whom 246 (6.5%) experienced the primary end point. Neither FPG nor HbA_1c predicted the primary outcome, whereas the 2h-PG, dichotomized as <7.8 vs. ≥7.8 mmol/L, was a significant predictor (hazard ratio 1.38, 95% CI 1.07–1.78; P = 0.01). During follow-up, diabetes developed in 78 of the 2,609 patients (3.0%) without diabetes at baseline. An FPG between 6.1 and 6.9 mmol/L did not predict incident diabetes, whereas HbA_1c 5.7–6.5% and 2h-PG 7.8–11.0 mmol/L were both significant independent predictors.

CONCLUSIONS The 2h-PG, in contrast to FPG and HbA_1c, provides significant prognostic information regarding cardiovascular events in patients with CAD. Furthermore, elevated 2h-PG and HbA_1c are significant prognostic indicators of an increased risk of incident diabetes.

目的建议使用三种检测方法来鉴定血糖异常：空腹血糖（FPG），口服葡萄糖耐量试验（OGTT）的2小时负荷后葡萄糖（2h-PG）和糖化血红蛋白A _1c（HbA _1c）。这项研究探讨了这些筛查测试对冠心病（CAD）患者的预后价值。

研究设计和方法FPG，2h-PG和HbA _1c用于筛查4,004名无糖尿病史（年龄18-80岁）的CAD患者的血糖异常。在随访2年后研究了这些检查的预后价值。主要终点包括心血管疾病死亡率，非致命性心肌梗塞，中风或因心力衰竭住院和糖尿病的次要终点。

结果3775名患者（94.3％）获得了包括所有三个血糖参数的完整信息，其中246名（6.5％）经历了主要终点。FPG和HbA _1c均未预测主要结果，而2h-PG分别为<7.8 vs.≥7.8mmol / L则不能作为主要预测指标（危险比1.38，95％CI 1.07-1.78；P = 0.01）。在随访期间，基线时没有糖尿病的2609例患者中有78例（3.0％）患了糖尿病。FPG在6.1至6.9 mmol / L之间不能预测糖尿病的发生，而HbA _1c 5.7–6.5％和2h-PG 7.8–11.0 mmol / L都是重要的独立预测因子。

结论与FPG和HbA _1c相比，2h-PG可提供有关CAD患者心血管事件的重要预后信息。此外，升高的2h-PG和HbA _1c是增加患糖尿病风险的重要预后指标。