The Impact of Prediabetes on Two-Year Clinical Outcomes in Patients Undergoing Elective Percutaneous Coronary Intervention.

Abstract

PURPOSE:

Prediabetes is an independent risk factor for cardiovascular disease. However, data on the long term adverse clinical outcomes of prediabetic patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) are scarce.

MATERIALS AND METHODS:

The study population comprised 674 consecutive non-diabetic patients who underwent elective PCI between April 2007 and November 2010. Prediabetes was defined as hemoglobin A1c (HbA1c) of 5.7% to 6.4%. Two-year cumulative clinical outcomes of prediabetic patients (HbA1c of 5.7% to 6.4%, n=242) were compared with those of a normoglycemic group (<5.7%, n=432).

RESULTS:

Baseline clinical and angiographic characteristics were similar between the two groups, except for higher glucose levels (104.8±51.27 mg/dL vs. 131.0±47.22 mg/dL, p<0.001) on admission in the prediabetes group. There was no significant difference between the two groups in coronary angiographic parameters, except for a higher incidence of diffuse long lesion in the prediabetes group. For prediabetic patients, trends toward higher incidences of binary restenosis (15.6% vs. 9.8 %, p=0.066) and late loss (0.71±0.70 mm vs. 0.59±0.62 mm, p=0.076) were noted. During the 24 months of follow up, the incidence of mortality in prediabetic patients was higher than that in normoglycemic patients (5.5% vs. 1.5%, p=0.007).

CONCLUSION:

In our study, a higher death rate and a trend toward a higher incidence of restenosis in patients with prediabetes up to 2 years, compared to those in normoglycemic patients, undergoing elective PCI with contemporary DESs.

• Authors: Woong Gil Choi, Seung Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 59 Issue 4 Pg. 489-494 (Jun 2018) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 29749131 (Publication Type: Comparative Study, Journal Article)
• Copyright: © Copyright: Yonsei University College of Medicine 2018.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A

Topics

• Aged
• Blood Glucose (metabolism)
• Coronary Angiography (methods)
• Coronary Restenosis (mortality)
• Drug-Eluting Stents (adverse effects)
• Elective Surgical Procedures (adverse effects)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Incidence
• Middle Aged
• Percutaneous Coronary Intervention (adverse effects, methods)
• Prediabetic State (blood, complications, epidemiology)
• Retrospective Studies
• Risk Factors
• Survival Rate
• Time Factors
• Treatment Outcome