Yonsei Med J.  2018 Jun;59(4):489-494. 10.3349/ymj.2018.59.4.489.

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

• Choi WG
• Rha SW
• Choi BG
• Choi SY
• Byun JK
• Mashaly A
• Park Y
• Jang WY
• Kim W
• Choi JY
• Park EJ
• Na JO
• Choi CU
• Kim EJ
• Park CG
• Seo HS

• KMID: 2410903
• DOI: http://doi.org/10.3349/ymj.2018.59.4.489

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.

Keyword

Hemoglobin A1c; prediabetes; percutaneous coronary intervention; drug-eluting stent

MeSH Terms

Cardiovascular Diseases
Drug-Eluting Stents
Follow-Up Studies
Glucose
Humans
Incidence
Mortality
Percutaneous Coronary Intervention*
Prediabetic State*
Risk Factors
Glucose

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