|
KMID : 0338420210360061365
|
|
The Korean Journal of Internal Medicine
2021 Volume.36 No. 6 p.1365 ~ p.1376
|
|
|
Long-term effects of the mean hemoglobin A1c levels after percutaneous coronary intervention in patients with diabetes
|
|
Bae Jae-Kyung
Yoon Ji-Hyung
Lee Jung-Hee
Nam Jong-Ho
Lee Chan-Hee
Son Jang-Won
Kim Ung
Park Jong-Seon
Shin Dong-Gu
|
|
|
Abstract
|
|
|
Background/Aims: The clinical benefit of strict blood glucose-lowering therapy for patients with coronary artery disease (CAD) is still debated. We aimed to evaluate the long-term outcomes of patients with diabetes who underwent percutaneous coronary intervention (PCI), according to the mean hemoglobin A1c (HbA1c) level after PCI.
Methods: We evaluated 675 diabetes patients with CAD treated with PCI. We categorized the study population into three groups based on the mean observed HbA1c levels during the follow-up duration, as follows: aggressive control (AC) group (HbA1c level < 6.5%, n = 148), moderate control (MC) group (HbA1c level ≥ 6.5% and < 7.0%, n = 138), and uncontrolled (UC) group (HbA1c level ≥ 7.0%, n = 389). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction, repeat target vessel revascularization, and stroke.
Results: The mean HbA1c level of the AC group was significantly lower than that of the MC and UC groups (6.04% ± 0.36% vs. 6.74% ± 0.14% vs. 8.39% ± 1.20%, p < 0.001). The incidence of MACCEs was significantly lower in the AC group than in the MC and UC groups (16.0% vs. 24.3% vs. 26.3%, p = 0.010), mostly driven by the incidence of stroke (4.4% vs. 14.0% vs. 11.4%, p = 0.013). Multivariate Cox regression analysis showed that only the AC group was associated with a reduced rate of MACCEs (hazard ratio, 0.499; 95% confidence interval, 0.316 to 0.786; p = 0.004) compared with the UC group.
Conclusions: Our study showed that intensive glycemic control (HbA1c level < 6.5%) is associated with improved clinical outcomes after PCI in patients with diabetes.
|
|
|
KEYWORD
|
|
|
Coronary artery disease , Diabetes mellitus , Percutaneous coronary intervention , Glycated hemoglobin A , Treatment outcome
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|
|