Impact of Glycemic Control on the Clinical Outcome in Diabetic Patients With Percutaneous Coronary Intervention : From the FU-Registry

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Background: It is not yet clear whether glycemic control affects the clinical outcome of percutaneous coronary intervention (PCI) in diabetic patients. Methods and Results: This study compared the effects of glycemic control on the clinical outcome in 2 groups of patients with diabetes mellitus (DM) who underwent PCI: a poor-glycemic-control group, who showed greater than 6.9% HbA1c at the time of PCI (Pre-HbA1c) (`≥6.9 group, n=334 patients) and a good-glycemic-control group, who showed less than <6.9% at Pre-HbA1c (`<6.9 group, n=212 patients). The patients in the ≥6.9 group were further divided into 2 groups for further comparisons: a `DM control group and a `Poor control group. At follow-up (300 days), the incidence of major adverse cardiac event (MACE) was significantly (P<0.05) lower in the <6.9 group (18.4% vs. 26.2%). However, there was no difference in MACE between the DM control group and the Poor control group. In a multivariate analysis, there was no relationship between the incidence of MACE and Pre-HbA1c, Pre-HbA1c≥6.9% or the HbA1c difference (Pre-HbA1c-HbA1c at follow-up). Conclusions: Clinical outcomes in the <6.9 group were superior to those in the ≥6.9 group as pre-PCI glycemic control affected the baseline characteristics. The results suggested that glycemic control started at PCI was not associated with an improvement in the clinical outcome at follow-up. (Circ J 2011; 75: 791-799)
2011-03-25