Impact of Glycemic Control on the Clinical Outcome in Diabetic Patients With Percutaneous Coronary Intervention From the FU-Registry

• Published in: Circulation Journal Vol. 75; no. 4; pp. 791 - 799
• Main Authors: Ike, Amane, Nishikawa, Hiroaki, Shirai, Kazuyuki, Mori, Ken, Kuwano, Takashi, Fukuda, Yusuke, Takamiya, Yosuke, Yanagi, Daizaburo, Kubota, Kazumitsu, Tsuchiya, Yoshihiro, Zhang, Bo, Miura, Shin-ichiro, Saku, Keijiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2011
• Subjects: Aged; Angioplasty, Balloon, Coronary; Blood Glucose; Clinical outcome; Diabetes mellitus; Diabetic Angiopathies - blood; Diabetic Angiopathies - therapy; Female; Follow-Up Studies; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; Glycemic control; Glycemic Index; Humans; Male; Middle Aged; Percutaneous coronary intervention
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-10-0474

Background: It is not yet clear whether glycemic control affects the clinical outcome of percutaneous coronary intervention (PCI) in diabetic patients. Methods and Results: This study compared the effects of glycemic control on the clinical outcome in 2 groups of patients with diabetes mellitus (DM) who underwent PCI: a poor-glycemic-control group, who showed greater than 6.9% HbA1c at the time of PCI (Pre-HbA1c) (`≥6.9 group', n=334 patients) and a good-glycemic-control group, who showed less than <6.9% at Pre-HbA1c (`<6.9 group', n=212 patients). The patients in the ≥6.9 group were further divided into 2 groups for further comparisons: a `DM control group' and a `Poor control group'. At follow-up (300 days), the incidence of major adverse cardiac event (MACE) was significantly (P<0.05) lower in the <6.9 group (18.4% vs. 26.2%). However, there was no difference in MACE between the DM control group and the Poor control group. In a multivariate analysis, there was no relationship between the incidence of MACE and Pre-HbA1c, Pre-HbA1c≥6.9% or the HbA1c difference (Pre-HbA1c-HbA1c at follow-up). Conclusions: Clinical outcomes in the <6.9 group were superior to those in the ≥6.9 group as pre-PCI glycemic control affected the baseline characteristics. The results suggested that glycemic control started at PCI was not associated with an improvement in the clinical outcome at follow-up. (Circ J 2011; 75: 791-799)