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Published on: May 14, 2013
Fasting blood glucose predicts high risk of in-stent restenosis in patients undergoing primary percutaneous coronary
Ge-Cai Chen1,2, Xu Huang1, Zhong-Bao Ruan2
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, PR China.
Insights
Higher fasting blood glucose (FBG) levels are linked to an increased risk of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). This association remains significant across various patient subgroups.
Area of Science:
- Cardiovascular Medicine
- Metabolic Health
- Interventional Cardiology
Background:
- Fasting blood glucose (FBG) is a known prognostic indicator in coronary heart disease (CHD) patients post-percutaneous coronary intervention (PCI).
- The specific relationship between FBG levels and in-stent restenosis (ISR) following PCI remains incompletely understood.
Purpose of the Study:
- To investigate the association between fasting blood glucose levels and the incidence of in-stent restenosis in patients with coronary heart disease who have undergone PCI.
- To clarify the predictive value of FBG for ISR development in this patient population.
Main Methods:
- A cohort study involving 531 patients with CHD undergoing PCI.
- Statistical analyses included logistic regression, receiver operating characteristic (ROC) curves, subgroup analysis, and restricted cubic spline (RCS) modeling.
- FBG levels were assessed as both categorical and continuous variables.
Main Results:
- A total of 124 (23.4%) patients developed ISR.
- Higher FBG levels were significantly associated with a higher incidence of ISR (p=0.002).
- Multivariable analysis confirmed that elevated FBG independently predicted higher ISR risk (OR: 1.89, p=0.005 as categorical; OR: 1.12, p=0.011 as continuous). ROC analysis indicated FBG's association with ISR (AUC=0.577, p=0.013).
Conclusions:
- Elevated fasting blood glucose levels are closely associated with an increased risk of in-stent restenosis in patients with coronary heart disease after percutaneous coronary intervention.
- The positive linear association between FBG and ISR risk was consistent across various subgroups, suggesting FBG as a potential biomarker for ISR.
Abstract:
Objectives. Studies have shown that fasting blood glucose (FBG) is closely associated with poor prognosis in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), but its association with in-stent restenosis (ISR) is still unclear. Therefore, this study was to explore the association between FBG with ISR in patients with CHD after PCI. Design. In this cohort study, we included 531 patients with CHD who underwent PCI. Logistic regression, receiver operating characteristic (ROC), subgroup analysis and restricted cubic spline (RCS) were used to assess the association between FBG with ISR. Results. A total of 124 (23.4%) patients had ISR. Patients with higher levels of FBG had higher incidence of ISR compared to those with lower levels of FBG (p = 0.002). In multivariable logistic regression analyses, higher levels of FBG remained strongly associated with higher risk of ISR (as a categorical variable, OR: 1.89, 95% CI: 1.21-2.94, p = 0.005; as a continuous variable, OR: 1.12, 95% CI: 1.03-1.23, p = 0.011). ROC analysis also showed that FBG might be associated with the occurrence of ISR (AUC = 0.577, 95% CI: 0.52-0.64, p = 0.013). Subgroup analyses showed the association of FBG with ISR was also stable in several subgroups (< 60 years or ≥ 60 years, male, with or without smoking, without diabetes and without hypertension). And RCS analysis showed that FBG was linearly and positively associated with the risk of ISR. Higher levels of FBG were closely associated with higher risk of ISR in patients with CHD after PCI.
