The SWEETHeart Study- Early detection of impaired glucose regulation post myocardial infarction

Principal Investigators: Professor Kamlesh Khunti and Professor Melanie Davies

Other key staff: Dr Nitin Gholap, Mr Steve Hiles, Dr Laura Gray, Dr Samiul Mostafa, Professor Iain Squire, Dr Gerry McCann and Mr Bill O’ Leary

Partners involved: University Hospitals of Leicester NHS Trust and NHS Leicester City

Summary: There are numerous reports on the high prevalence and adverse impacts of newly detected chronic hyperglycaemia including type 2 diabetes (T2DM) and impaired glucose regulation (IGR) in patients admitted with an acute myocardial infarction (MI). Furthermore traditional risk factors such as obesity, hypertension and hyperlipidaemia fail to explain this adverse relationship between chronic hyperglycaemia and coronary heart disease (CHD). T2DM and IGR are much more common in the South Asian (SA) population and seem to be a key factor driving the excess CHD risk in this population. However, information on the prevalence and predictive significance of the whole range of chronic hyperglycaemia in patients with acute MI from a mixed ethnic population in the UK is limited.

This study is aiming to recruit 552 patients with previously unknown T2DM from the University Hospitals of Leicester following an acute MI. Before discharge from hospital, participants will have a Standard Oral Glucose Tolerance Test (OGTT) as well as other samples for assessment. Follow up is at 6-8 weeks, and again at 12 months, with hospital re-admission rate, cardiovascular event rate and mortality rate also determined. Long-term follow ups will be conducted at 2, 5 and 10 years time.

Aims:

• Compare the prevalence of diabetes and non-diabetic hyperglycaemia post MI in South Asians and Europeans
• Assess if early detection of such abnormalities using OGTT/ HbA1c in the course of acute coronary syndrome (ACS) will help identify high risk patients who are likely to have a worse prognosis
• Study the profile and difference of several biomarkers in post ACS period and their correlation to short and long-term prognosis in South Asian and White European patients
• Develop a predictive risk score model based on the use of traditional and novel risk factors to help screen high risk patients who are likely to have adverse clinical outcomes post MI

Further information: If you would like to be involved in this project, or for more information, please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Start date: 09/2010                                                                                                      Expected end date: 03/2012

Study outcomes:

• The Primary outcome is to compare prevalence of screen detected T2DM , impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) post myocardial infarction in White Europeans and South Asians
• Secondary outcomes include comparing across the spectrum of glucose intolerance, WE and SA ethnic study groups in terms of insulin sensitivity and insulin secretion, levels of novel biomarkers, levels of physical activity, dietory habits, level of emotional distress, health related quality of life and difference in the adverse clinical outcomes

The knowledge of the traditional and novel risk factors determining adverse clinical outcomes post MI can potentially help early identification of high risk people from a mixed ethnic population following an MI, and help develop strategies for intervention targeted at at-risk groups.