Details

Autor(en) / Beteiligte

• Kok, Marlies M
• von Birgelen, Clemens
• Sattar, Naveed
• Zocca, Paolo
• Löwik, Marije M
• Danse, Peter W
• Schotborgh, Carl E
• Scholte, Martijn
• Hartmann, Marc
• Kant, Gert D
• Doelman, Cees
• Tjon Joe Gin, Melvyn
• Stoel, Martin G
• van Houwelingen, Gert
• Linssen, Gerard C M
• IJzerman, Maarten J
• Doggen, Carine J M
• van der Heijden, Liefke C

Titel

Prediabetes and its impact on clinical outcome after coronary intervention in a broad patient population

Ist Teil von

• EuroIntervention, 2018-10, Vol.14 (9), p.e1049-e1056

Ort / Verlag

France

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. 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). 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.