Key result
A previously known history of diabetes was the only independent predictor of revascularization (OR 2.03), non-fatal acute myocardial infarction (OR 2.70), and readmission for heart failure (OR 3.82) after percutaneous coronary intervention.
Cohort (n=374)
No
Odds Ratio: 2.03 (95% CI 1.09–3.77)
p-value: p=0.025
Although impaired glucose metabolism is highly prevalent in patients undergoing PCI, only previously known diabetes, and not newly detected diabetes or pre-diabetes, independently predicts long-term cardiovascular events.
BACKGROUND: Clinical practice guidelines recommend ad hoc screening of diabetes in patients admitted for macrovascular disease; however, these recommendations are rarely followed in real practice. This study was undertaken to assess whether impaired glucose metabolism, newly diagnosed after percutaneous coronary intervention (PCI) or known diabetes, provides prognostic information. METHODS: We studied 374 patients who underwent PCI. An oral glucose tolerance test was carried out in the known non-diabetic patients with fasting glucose < 7 mmol/L. RESULTS: Eighty-one percent of the patients presented impaired glucose metabolism, from which 35.3% were previously diagnosed with diabetics, 21.4% were newly detected diabetics, and 24.3% were pre-diabetics. After a mean follow-up of 35.8 ± 13.4 months, only a known history of diabetes was an independent predictor of revascularization (OR = 2.03, p = 0.025), non-fatal acute myocardial infarction (OR = 2.70, p = 0.029) and readmission due to heart failure during the follow-up (OR = 3.82, p = 0.022). CONCLUSIONS: Screening for impaired glucose metabolism after PCI permits the detection of a high proportion of patients with abnormal glucose regulations. However, previously known diabetes remains the only independent predictor of cardiovascular events in the follow-up.
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Jiménez‐Navarro et al. (2014) conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention (n=374). Known diabetes vs. No previously known history of diabetes (normal glucose metabolism, pre-diabetes, or newly detected diabetes) was evaluated on Revascularization during follow-up (OR 2.03, 95% CI 1.09-3.77, p=0.025). A previously known history of diabetes was the only independent predictor of revascularization (OR 2.03), non-fatal acute myocardial infarction (OR 2.70), and readmission for heart failure (OR 3.82) after percutaneous coronary intervention.
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