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KMID : 0311120180590040489
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Yonsei Medical Journal
2018 Volume.59 No. 4 p.489 ~ p.494
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The Impact of Prediabetes on Two-Year Clinical Outcomes in Patients Undergoing Elective Percutaneous Coronary Intervention
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Choi Woong-Gil
Rha Seung-Woon
Choi Byoung-Geol
Choi Se-Yeon
Byun Jae-Kyeong
Mashaly Ahmed
Park Yoon-Jee
Jang Won-Young
Kim Woo-Hyeun
Choi Jah-Yeon
Park Eun-Jin
Na Jin-Oh
Choi Cheol-Ung
Kim Eung-Ju
Park Chang-Gyu
Seo Hong-Seog
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Abstract
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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.
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KEYWORD
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Hemoglobin A1c, prediabetes, percutaneous coronary intervention, drug-eluting stent
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