الفهرس 
Diabetes mellitus, pre diabetes andOnly 14 pages are availabe for public view
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Abstract
Epidemiologic evidence suggests that the complications of diabetes begin early in the progression from normal glucose tolerance to frank diabetes. Pre diabetes, defined as people with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), some of whom in fact already have the characteristic microvascular changes resulting from diabetes itself.
This study aimed to determine the short term outcomes as regards major adverse cardiac & cerebral events MACCE: (death, acute coronary syndrome: myocardial infarction & unstable angina, cerebrovascular stroke, target vessel revascularization) in prediabetic patients as compared to diabetic and non diabetic patients undergoing elective percutaneous coronary intervention (PCI) .
This study was conducted on 108 patients presenting to Ain-Shams university catheterization laboratory for elective percutaneous coronary intervention by bare metal stents in the period from September 2009 to June 2010 (48 diabetic patient, 30 pre diabetic patient and 30 non diabetic level patient) .
Each patient was subjected to the following: full medical history taking, clinical examination, laboratory investigations including serum creatinine, fasting and 2 hours post prandial glucose levels and echocardiography. All patients underwent bare metal stents deployment either preceded by balloon dilatation or not.
Follow up was done at 3 and 6 months for major adverse cardiac & cerebral events (cardiovascular death, acute coronary syndrome, cerebrovascular stroke, target vessel revascularization).
Data were collected, verified, revised and edited, then statistically analyzed.
Our findings demonstrate that there was no statistically significant difference between patients of the 3 different study groups (diabetics= 18.8%, pre diabetics= 13.3%, non diabetics= 3.3% , p-value = 0.1) regarding composite end point of death, stroke, acute coronary syndrome and target vessel revascularization at 3 months follow up, but there was high statistical difference between them regarding acute coronary syndrome (diabetics =43%, pre diabetics = 26%, non diabetics= 10% , p-value = 0.006) at 6 months follow up.
Independent predictors of acute coronary syndrome at 6 months were male gender, diabetes mellitus, smoking, stent length more than13 mm and stent diameter equal or less than 2.75 mm, while male gender, smoking and stent diameter equal or less than 2.75mm were independent predictors of target vessel revascularization at 6 months .
To conclude, prediabetes, though not a disease entity by itself, is associated with of risk for both macrovascular and increasingly, microvascular pathology. It is important to identify these conditions to prevent incident diabetes and to take measures to stop the vascular complications. Our study findings revealed that complications of diabetes may begin as early as patients are suffering impaired glucose homeostasis, which warrants further evaluation in larger studies.