Glycemic control and outcome after carotid intervention in patients with T2D: A Swedish nationwide cohort study
Alexander Zabala1, Anders Gottsäter2,3, Marcus Lind4,5
1Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Sweden.
Aims:
To investigate the association between glycemic control and outcome in people with type 2 diabetes (T2D) after carotid intervention due to carotid stenosis.
Methods:
Observational nationwide population-based cohort study using inverse probability treatment weighting (IPTW) and Cox regressions with covariates, that is, 4 stepwise models, investigating the relationship between terciles of glycated hemoglobin (HbA1c) levels and stroke or death.
Results:
1115 subjects with T2D undergoing carotid intervention were included during Jan 1st 2009 to Dec 31st 2015. Divided into terciles, with a mean HbA1c level of 44 (tercile 1), 53 (tercile 2), and 72 (tercile 3) mmol/mol. By using IPTW and Cox regression, each model was stepwise introduced for the investigating of relative risks, that is, hazard ratios (HRs) with associated 95% confidence intervals (CI). There was a significant increased risk for stroke or death, in every model observed for tercile 3, compared to tercile 1: HR for model 4: 1.35 (95% CI 1.02-1.78). No difference for stroke or death within 30 days was observed between the groups.
Conclusion:
Poor glycemic control in people with T2D after carotid intervention is associated with an increased long-term risk for stroke or death.
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