The Effect of Glycemic Control on Cardiac Outcomes in Saudi Diabetic Patients who Underwent Coronary Angiogram
Mohammed Ali Balghith1, Ahmed Ammar Almutairi1, Ibrahim Abdulelah Almohini1
1King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Insights
Poor glycemic control in diabetic patients undergoing cardiac procedures is linked to higher rates of percutaneous coronary intervention (PCI) and readmissions. Coronary artery bypass graft (CABG) surgery was associated with fewer complications.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Diabetes mellitus is a metabolic disorder affecting insulin secretion and cellular function.
- Glycated hemoglobin (HbA1c) is a key indicator of long-term glucose control.
- Diabetes increases the risk of cardiovascular complications, including acute coronary syndrome, often requiring interventions like PCI or CABG.
Purpose of the Study:
- To assess the impact of glycemic control, measured by HbA1c, on cardiac complications in Saudi diabetic patients.
- To compare outcomes between patients who underwent percutaneous coronary intervention (PCI) and Coronary Artery Bypass Graft (CABG).
Main Methods:
- A retrospective cohort study involving 379 diabetic patients aged 50-70.
- Patients were categorized based on HbA1c levels (<7.5% vs. ≥7.5%).
- Data on HbA1c, intervention type, and cardiac outcomes were collected over a 3-year follow-up period. Excluded patients with renal failure, liver dysfunction, type 1 diabetes, or cancer.
Main Results:
- Patients with uncontrolled HbA1c (≥7.5%) were more likely to undergo PCI (P=0.04).
- The controlled HbA1c group showed a higher likelihood of receiving medical treatment (P=0.001).
- Uncontrolled HbA1c post-intervention correlated with increased hospital readmissions (P=0.018).
Conclusions:
- Elevated HbA1c levels in diabetic patients are associated with increased likelihood of PCI and higher readmission rates.
- Coronary Artery Bypass Graft (CABG) was linked to a lower risk of cardiac complications.
- Further research is needed to explore optimal diabetes management strategies for preventing adverse cardiovascular outcomes in this population.
Background:
Diabetes mellitus is a metabolic disorder that causes impaired insulin secretion or cellular dysfunction. Glycated hemoglobin (HbA1c) indicates the long-term level of glucose. Diabetes can lead to cardiovascular complications such as acute coronary syndrome , which might require coronary intervention.
Objectives:
The aim of this study was to estimate the effect of glycemic control measured by HbA1c levels on cardiac complications in Saudi diabetic patients who underwent percutaneous coronary intervention (PCI) or Coronary artery bypass graft (CABG).
Methodology:
It was a cohort retrospective study conducted at King Abdulaziz Cardiac Center with a total sample size of 379 patients. The charts of all those diabetic patients were reviewed and their HbA1c level, type of intervention were compared to determine their effect on cardiac outcomes and complications. Inclusion criteria involved the age group 50-70 years within follow-up period of 3 years. Any patient known to have renal failure, liver dysfunction, type one diabetes, and cancer were excluded. The HbA1c level was divided into two groups (<7.5%, ≥7.5%).
Results:
Total sample size was 379, and the mean age was (60.33 ± 5.98) with male being (66.5%). HbA1c levels at admission were (mean 9.15 ± 2.03), whereas the mean after 3 years was (8.629 ± 1.518). The uncontrolled group was more likely to have PCI (n = 302), in comparison to the controlled group (n = 77) with a P value of 0.04. However, the controlled group was more likely to undergo medical treatment P value of 0.001. Patients with uncontrolled Hba1c after the intervention had a higher readmission rate with a P value of 0.018.
Conclusions:
Patients with an elevated level of HbA1c were more likely to be managed with PCI. Furthermore, they are at a higher risk of multiple readmissions. Patients who had CABG were at a lower risk of cardiac complications. Further studies are required in our population to consider different approaches of diabetes control for preventing adverse outcomes.
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