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Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II

Roberto A Corpus1, Peter B George, John A House

  • 1Division of Cardiology and Biostatistics, Mid America Heart Institute, St. Luke's Hospital, Kansas City, Missouri, USA. rjcorpus@yahoo.com

Journal of the American College of Cardiology
|January 13, 2004
PubMed

Insights

Optimal glycemic control (hemoglobin A1c < or =7%) in diabetic patients undergoing percutaneous coronary intervention (PCI) is linked to lower rates of target vessel revascularization (TVR). Achieving this control improves clinical outcomes after PCI.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Medicine

Background:

  • Diabetes mellitus (DM) patients have worse outcomes post-PCI.
  • DM patients experience higher rates of restenosis after PCI.

Purpose of the Study:

  • To assess the relationship between glycemic control (hemoglobin A1c) and target vessel revascularization (TVR).
  • To evaluate the impact of glycemic control on outcomes in diabetic patients undergoing elective percutaneous coronary intervention (PCI).

Main Methods:

  • 239 patients (179 with DM) undergoing elective PCI were studied.
  • Optimal glycemic control defined as hemoglobin A1c (A1c) ≤7%; suboptimal as A1c >7%.
  • Follow-up at 6 and 12 months post-intervention.

Main Results:

  • Diabetic patients with A1c >7% had higher TVR rates (34%) vs. A1c ≤7% (15%).
  • A1c >7% independently predicted TVR (OR 2.87, p=0.03).
  • Optimal glycemic control correlated with lower cardiac rehospitalization (15%) and recurrent angina (13%).

Conclusions:

  • Optimal glycemic control (A1c ≤7%) in diabetic PCI patients reduces TVR, rehospitalization, and angina.
  • Aggressive DM management to achieve A1c ≤7% benefits post-PCI clinical outcomes.
Abstract

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