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Major Adverse Cardiovascular Events in Insulin- Versus Non-Insulin-Treated Type 2 Diabetes Patients Following
Ayesha Tariq1, Zohra Bhatti2, Amer Hayat Khan3
1Department of Pharmacy, The University of Lahore, Lahore, Pakistan.
Background:
Insulin-treated type 2 diabetes millatus (ITDM) is associated with heigher cardiovascular risk profile. However its impact on major adverse cardiovascular events (MACE) following poorer percutaneous coronary intervention (PCI) remains unclear.
Aims:
This study aimed to evaluate major adverse cardiovascular events in insulin-treated diabetes mellitus (ITDM) and non-insulin-treated diabetes mellitus (Non-ITDM) type 2 diabetes mellitus (T2DM) patients' post-PCI.
Methods:
A single-center prospective cohort study was conducted in which 465 T2DM patients undergoing PCI and completing the 1-year follow-up were enrolled. Patients were divided into two groups based on their therapy for DM: ITDM and Non-ITDM. The primary endpoint was MACE, a composite of non-fatal myocardial infarction (MI), stroke, coronary artery bypass grafting (CABG), repeat PCI, and mortality.
Results:
Logistic regression confirmed higher odds of MACE among ITDM compared to Non-ITDM patients (unadjusted OR = 1.743, 95% CI: 0.865-3.512, p = 0.120; adjusted OR = 1.729, 95% CI: 0.822-3.635, p = 0.149). Kaplan-Meier analysis illustrated increased cumulative incidence of MACE among ITDM over 12 months (Log rank p = 0.113). Similarly, Cox proportional hazards analysis reported higher hazard ratios in the insulin-treated group (unadjusted HR = 1.695, 95% CI: 0.874-3.284, p = 0.118; adjusted HR = 1.554, 95% CI: 0.793-3.045, p = 0.199). Yet the results were not statistically significant. Overall, a higher incidence of MACE was reported among ITDM (12.5%) compared to Non-ITDM (7.5%), particularly repeat PCI (4.8% vs. 2.5%) and stroke (3.8% vs. 1.4%) among T2DM patients after PCI.
Conclusion:
T2DM patients receiving insulin therapy had a higher incidence of adverse cardiovascular events compared to those not on insulin treatment, that insulin-treated patients may represent a higher-risk group for MACE following PCI.
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