Glycemic control does not predict prognosis in patients with angina pectoris

Markers in urine and blood can reveal diabetes risk in patients with angina pectoris, according to the PhD thesis of Eirik Wilberg Rebnord.


MAIN RESULTS:

  1. HbA1c does not predict prognosis in patients with angina pectoris.
  2. Kynurenine:tryptophan-ratio in urine is associated with increased risk of type 2 diabetes in angina patients.
  3. Patients with angina and high levels of serum carnitine metabolites have increased risk of type 2 diabetes.

THESIS DEFENCE:

Thesis: Biomarkers of metabolism and inflammation as predictors of coronary events and type 2 diabetes in patients with stable coronary artery disease – Prospective studies from the Western Norway Coronary angiography cohort
Candidate: Eirik Wilberg Rebnord
Time: November 2, 2018 at 11:15
Place: Haukeland University Hospital, Armauer Hansen House: Auditorium
Link to university website (in Norwegian)


SUMMARY:

(1) Glycated hemoglobin levels does not seem to influence the risk of an acute myocardial infarction or sudden cardiac death in patients with stable coronary artery disease. 2519 patients with suspected angina pectoris were included in the study between 2000 and 2004, and followed until 2006. There was no significant association between HbA1c and prognosis.

(2) A high kynurenine:tryptophan ratio measured in urine is linked to more than doubled risk of incident type 2 diabetes in patients with stable coronary artery disease. There was no association between kynurenine:tryptophan ratio in blood and risk of diabetes. The patients were followed for a median of 7.6 years.

(3/4) Patients with suspected angina pectoris and dysfunctional fatty acid metabolism have increased risk of type 2 diabetes. Higher levels of the carnitine metabolites trimethyllysine, butyrobetaine and palmitoylcarnitine independently predicted risk in patients followed for median 7.7 years.


REFERENCES:

(1) Rebnord, E. W., Pedersen, E. R., Strand, E., Svingen, G. F. T., Meyer, K., Schartum-Hansen, H., Løland, K. H., Seifert, R., Ueland, P. M., Nilsen, D. W. T., Nordrehaug, J. E., & Nygård, O. (2015). Glycated hemoglobin and long-term prognosis in patients with suspected stable angina pectoris without diabetes mellitus: a prospective cohort studyAtherosclerosis240(1), 115-120.

(2) Rebnord, E. W., Strand, E., Midttun, Ø., Svingen, G. F., Christensen, M. H., Ueland, P. M., Mellgren, G., Njølstad, P. R., Tell, G. S., Nygård, O. K. & Pedersen, E. R. (2017). The kynurenine: tryptophan ratio as a predictor of incident type 2 diabetes mellitus in individuals with coronary artery diseaseDiabetologia60(9), 1712-1721.

(3) Strand, E., Rebnord, E. W., Flygel, M. R., Lysne, V., Svingen, G. F., Tell, G. S., Løland, K. H., Berge, R. K., Svardal, A., Nygård, O., & Pedersen, E. R. (2018). Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients With Suspected Stable Angina PectorisThe Journal of Clinical Endocrinology & Metabolism103(3), 1033-1041.

(4) Rebnord, E. W., Strand, E., & Pedersen, E. R. (2018). Response to Letter to the Editor:“Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients With Suspected Stable Angina Pectoris”The Journal of Clinical Endocrinology & Metabolism103(11), 4039-4039.