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Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization

D Hasdai1, R A Rizza, D E Grill

  • 1Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.

American Heart Journal
|January 3, 2001
PubMed

Insights

This study found that the degree of blood sugar control in diabetic patients did not affect their long-term outcomes after successful percutaneous coronary revascularization (PCR). Good, moderate, or poor glycemic control showed no significant difference in survival rates post-procedure.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Diabetic patients undergoing percutaneous coronary revascularization (PCR) historically exhibit poorer clinical outcomes.
  • Understanding factors influencing post-PCR outcomes in this high-risk group is crucial for improving patient care.

Purpose of the Study:

  • To investigate the impact of glycemic control, measured by hemoglobin A1c (HbA1c) levels, on the long-term prognosis of diabetic patients following successful PCR.
  • To determine if pre-procedural hyperglycemia influences the risk of all-cause death or myocardial infarction after revascularization.

Main Methods:

  • A cohort of diabetic patients who underwent successful PCR between 1979 and 1998 was analyzed.
  • Glycemic control was assessed using hemoglobin A1c (HbA1c) levels, categorized as good (<8.0%), moderate (8.0%-10.0%), or poor (>10.0%).
  • Outcomes, including all-cause death and the composite of death/myocardial infarction, were evaluated over a median follow-up period of 3.2 to 4.7 years.

Main Results:

  • Analysis of HbA1c as a continuous variable showed no significant impact on mortality or the composite endpoint.
  • When analyzed categorically, patients with moderate and poor glycemic control did not demonstrate a significantly higher risk of death or death/myocardial infarction compared to those with good control.
  • Hazard ratios for death and death/myocardial infarction were comparable across all glycemic control categories.

Conclusions:

  • The degree of glycemic control at the time of percutaneous coronary revascularization does not appear to influence long-term outcomes in diabetic patients.
  • These findings suggest that factors other than immediate pre-procedural glycemic status may be more critical for determining post-PCR prognosis in this population.
Abstract

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