TY - JOUR
T1 - Prediabetes and its impact on clinical outcome after coronary intervention in a broad patient population
AU - Kok, Marlies M.
AU - Von Birgelen, Clemens
AU - Sattar, Naveed
AU - Zocca, Paolo
AU - Löwik, Marije M.
AU - Danse, Peter W.
AU - Schotborgh, Carl E.
AU - Scholte, Martijn
AU - Hartmann, Marc
AU - Kant, Gert D.
AU - Doelman, Cees
AU - Gin, Melvyn Tjon Joe
AU - Stoel, Martin G.
AU - Van Houwelingen, Gert
AU - Linssen, Gerard C.M.
AU - IJzerman, Maarten J.
AU - Doggen, Carine J.M.
AU - Van Der Heijden, Liefke C.
N1 - Funding Information:
The BIO-RESORT study was funded equally by Biotronik, Boston Scientific, and Medtronic.
Publisher Copyright:
© Europa Digital & Publishing 2018. All rights reserved.
PY - 2018/10
Y1 - 2018/10
N2 - Aims: It is unclear whether detection of prediabetes (pre-DM) by routine assessment of glycated haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) among patients undergoing percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) may help identify subjects with increased event risk. We assessed the relation between glycaemia status and one-year outcome after PCI. Methods and results: Glycaemia status was determined in 2,362 non-diabetic BIO-RESORT participants, treated at all four study sites, to identify pre-DM (HbA1c 42-47 mmol/mol; FPG 6.1-6.9 mmol/L) and unknown diabetes mellitus (DM) (HbA1c ≥48 mmol/mol; FPG ≥7.0 mmol/L). Another 624 patients had medically treated DM. The main composite endpoint consisted of death, myocardial infarction, or revascularisation. Glycaemic state was known in 2,986 participants: 324 (11%) patients had pre-DM, 793 (27%) had DM (known or new), and 1,869 (63%) patients had normoglycaemia. Pre-DM and DM patients differed from normoglycaemic patients in cardiovascular risk factors. The composite endpoint occurred in 11.1% in pre-DM, 10.5% in DM, and 5.7% in normoglycaemia (p<0.001). Pre-DM was associated with a twofold higher event risk compared to normoglycaemia (adj. HR 2.0, 95% CI: 1.4-3.0). Conclusions: Following PCI with contemporary DES, all-comers with pre-DM had significantly higher event risks than normoglycaemic patients. In non-DM patients requiring PCI, routine assessment of HbA1c and FPG appears to be of value to identify subjects with increased event risk.
AB - Aims: It is unclear whether detection of prediabetes (pre-DM) by routine assessment of glycated haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) among patients undergoing percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) may help identify subjects with increased event risk. We assessed the relation between glycaemia status and one-year outcome after PCI. Methods and results: Glycaemia status was determined in 2,362 non-diabetic BIO-RESORT participants, treated at all four study sites, to identify pre-DM (HbA1c 42-47 mmol/mol; FPG 6.1-6.9 mmol/L) and unknown diabetes mellitus (DM) (HbA1c ≥48 mmol/mol; FPG ≥7.0 mmol/L). Another 624 patients had medically treated DM. The main composite endpoint consisted of death, myocardial infarction, or revascularisation. Glycaemic state was known in 2,986 participants: 324 (11%) patients had pre-DM, 793 (27%) had DM (known or new), and 1,869 (63%) patients had normoglycaemia. Pre-DM and DM patients differed from normoglycaemic patients in cardiovascular risk factors. The composite endpoint occurred in 11.1% in pre-DM, 10.5% in DM, and 5.7% in normoglycaemia (p<0.001). Pre-DM was associated with a twofold higher event risk compared to normoglycaemia (adj. HR 2.0, 95% CI: 1.4-3.0). Conclusions: Following PCI with contemporary DES, all-comers with pre-DM had significantly higher event risks than normoglycaemic patients. In non-DM patients requiring PCI, routine assessment of HbA1c and FPG appears to be of value to identify subjects with increased event risk.
UR - http://www.scopus.com/inward/record.url?scp=85048203409&partnerID=8YFLogxK
U2 - 10.4244/EIJ-D-17-01067
DO - 10.4244/EIJ-D-17-01067
M3 - Article
C2 - 29313817
AN - SCOPUS:85048203409
SN - 1774-024X
VL - 14
SP - e1049-e1056
JO - EuroIntervention
JF - EuroIntervention
IS - 9
ER -