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Influence of diabetes on >10-year outcomes after percutaneous coronary intervention

Takatoshi Kasai1, Katsumi Miyauchi, Kan Kajimoto

  • 1Department of Cardiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Heart and Vessels
|May 20, 2008
PubMed

Insights

Diabetes significantly increases long-term mortality risk after percutaneous coronary intervention (PCI) in Asian patients. Elevated glycosylated hemoglobin (HbA1c) levels further heighten this risk, underscoring the importance of glycemic control.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Interventional Cardiology

Background:

  • Limited data exists on long-term outcomes after percutaneous coronary intervention (PCI) in Asian populations, particularly concerning diabetes.
  • The impact of glycosylated hemoglobin (HbA1c) levels on post-PCI outcomes in diabetic patients remains debated.

Purpose of the Study:

  • To investigate the long-term impact of diabetes mellitus (DM) on mortality following PCI in Japanese patients.
  • To assess the association between glycosylated hemoglobin (HbA1c) levels and mortality among diabetic patients undergoing PCI.

Main Methods:

  • A cohort of 748 Japanese patients (298 with DM, 450 without) who underwent PCI between 1984 and 1992 was analyzed.
  • Long-term follow-up, averaging 12.0 years, was conducted to ascertain total and cardiovascular mortality.
  • Statistical analysis, including hazard ratios (HR) and 95% confidence intervals (CI), was used to evaluate risk factors.

Main Results:

  • Diabetic patients exhibited significantly higher total mortality (15.8% vs. 9.1%, HR 1.71) and cardiovascular mortality (9.4% vs. 4.2%, HR 2.09) compared to non-diabetic patients.
  • Among diabetic patients, elevated HbA1c levels were independently associated with increased total mortality (HR 1.25) and cardiovascular mortality (HR 1.30).

Conclusions:

  • Diabetes mellitus is associated with increased long-term mortality after percutaneous coronary intervention, even in Asian populations.
  • Glycemic control, as indicated by HbA1c levels, is a critical factor influencing post-PCI outcomes in diabetic patients.

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