Prediabetes and coronary artery disease: Outcome after revascularization procedures

Juan Francisco Cueva-Recalde , José Ramón Ruiz-Arroyo , Francisco Roncalés García-Blanco
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Abstract

Objective

To assess the long-term association between prediabetes and an increased risk of cardiovascular events in patients with coronary artery disease and percutaneous coronary intervention (PCI).

Methods

A retrospective cohort study. We searched our database to identify all PCI procedures performed in 2010. Patients with no diabetes and HbA1c measurement in the index hospitalization were enrolled and divided into two groups based on HbA1c value: 5.7–6.5% for prediabetes and <5.7% for controls. Demographic, clinical, and procedure-related variables were recorded. Study endpoints were mortality, hospital admissions, myocardial infarction (MI), and revascularization procedures.

Results

The study population consisted of 132 subjects (82.6% males, age: 65.26 ± 12.46 years). No difference was found as regards distribution of demographic, clinical, and procedure-related variables. A majority (64.1%) of PCI procedures were performed for ST-segment elevation MI. Prevalence of prediabetes was 40.2%. After a mean follow-up period of 42.3 ± 3.6 months, no differences were found in outcomes between the prediabetes and control groups in total mortality (5.4% vs 1.9%; relative risk [RR] 2.86, 95% confidence interval [95% CI] 0.27–30.44; p = 0.56), non-cardiovascular mortality (2.7% vs 1.9%; RR 1.43, 95% CI 0.93–22.18; p = 0.79), hospital admissions (19% vs 25%; RR 1.13, 95% CI 0.73–1.73; p = 0.57), MI (3% vs 1%; RR 4.28, 95% CI 0.46–39.52; p = 0.30), or target lesion revascularization (3% vs 6%; RR 0.70, 95% CI 0.18–2.61; p = 0.72).

Conclusions

Prediabetes, as determined by HbA1c (5.7–6.5%), is not associated with long-term adverse cardiovascular outcomes in patients with CAD and PCI.

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糖尿病前期和冠状动脉疾病:血运重建术后的结果
目的评估冠状动脉疾病和经皮冠状动脉介入治疗(PCI)患者糖尿病前期与心血管事件风险增加之间的长期相关性。方法回顾性队列研究。我们搜索了我们的数据库,以确定2010年进行的所有PCI手术。在指数住院中没有糖尿病和HbA1c测量的患者被纳入,并根据HbA1c值分为两组:糖尿病前期为5.7-6.5%,<;对照组为5.7%。记录人口统计学、临床和手术相关变量。研究终点为死亡率、住院人数、心肌梗死(MI)和血运重建程序。结果研究人群包括132名受试者(82.6%为男性,年龄:65.26±12.46岁)。在人口统计学、临床和手术相关变量的分布方面没有发现差异。大多数(64.1%)PCI手术是针对ST段抬高型MI进行的。糖尿病前期的患病率为40.2%。经过42.3±3.6个月的平均随访,糖尿病前期组和对照组在总死亡率方面的结果没有差异(5.4%vs 1.9%;相对风险[RR]2.86,95%置信区间[95%CI]0.27–30.44;p=0.56),非心血管死亡率(2.7%对1.9%;RR 1.43,95%CI 0.93–22.18;p=0.79)、住院率(19%对25%;RR 1.13,95%CI 0.73–1.73;p=0.57)、心肌梗死(3%对1%;RR 4.28,95%CI 0.46–39.52;p=0.30)或靶病变血运重建(3%对6%;RR 0.70,95%CI 0.18–2.61;p=0.7 2),与CAD和PCI患者的长期不良心血管结局无关。
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