Key result
Achieving both LDL-C and TG targets post-PCI is not significantly linked to lower MACE in diabetics.
Why the study?
It was unknown whether good control of both LDL-C and triglycerides is associated with better long-term clinical outcomes after PCI in patients with diabetes.
Does controlling both LDL-C (<100 mg/dL) and TG (<175 mg/dL) improve long-term clinical outcomes in diabetic patients who have undergone PCI?
Observational (n=1,006)
Yes
Does controlling both LDL-C (<100 mg/dL) and TG (<175 mg/dL) improve long-term clinical outcomes in diabetic patients who have undergone PCI?
Absolute Event Rate: 27% vs 38%
p-value: p=0.074
Achieving dual target levels of LDL-C <100 mg/dL and TG <175 mg/dL is associated with reduced long-term coronary events in diabetic patients following PCI.
May support dual LDL-C/TG targets in diabetic post-PCI patients; hypothesis-generating and requires randomized confirmation.
Background: We investigated whether patients with diabetes who had good control of both low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) would be associated with better long-term clinical outcomes after percutaneous coronary intervention (PCI). Methods and Results: Using our PCI registry (Fu-Registry), the 1,006 cases with diabetes were divided into 4 groups: Group 1, LDL-C ≥100 mg/dL and TG ≥175 mg/dL; Group 2, LDL-C <100 mg/dL and TG ≥175 mg/dL; Group 3, LDL-C ≥100 mg/dL and TG <175 mg/dL; and Group 4, LDL-C <100 mg/dL and TG <175 mg/dL. The primary endpoint during the follow-up period (median follow up of 1,984 days) was defined as major adverse cardiac events (MACEs). Additionally, all coronary events were defined as a secondary endpoint. The incidence rates of MACEs were as follows: Group 1, 38%; Group 2, 26%; Group 3, 31%; and Group 4, 27% (P=0.074), and the rates tended to be higher in Group 1. All coronary events were as follows: Group 1, 66%; Group 2, 56%; Group 3, 58%; and Group 4, 51% (P=0.032). Conclusions: In patients with diabetes who underwent PCI, the LDL-C and TG levels in Group 4 met secondary prevention targets for coronary artery disease and these patients showed better long-term clinical outcomes compared with those in other groups.
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Maruo et al. (2024) conducted an observational in Diabetes and coronary artery disease requiring percutaneous coronary intervention (n=1,006). Achieving secondary prevention targets (LDL-C <100 mg/dL and TG <175 mg/dL) vs. Not achieving secondary prevention targets (LDL-C ≥100 mg/dL and TG ≥175 mg/dL) was evaluated on Major adverse cardiac events (MACEs) (p=0.074). Diabetic patients who achieved secondary prevention targets for both LDL-C and TG after PCI had a 27% incidence of major adverse cardiac events compared to 38% in those meeting neither target (P=0.074).
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