The Impact of Prediabetes on Two-Year Clinical Outcomes in Patients Undergoing Elective Percutaneous Coronary Intervention
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Key result
Prediabetes was not associated with a statistically significant increase in the primary composite endpoint of major adverse cardiac events at 24 months compared to normoglycemia (15.1% vs. 10.2%, OR 1.61).
Why the study?
Does prediabetes increase the risk of major adverse cardiac events and mortality in non-diabetic patients undergoing elective PCI with drug-eluting stents?
Study Design
Type
Cohort (n=674)
Multicenter
No
Structured PICO
Does prediabetes increase the risk of major adverse cardiac events and mortality in non-diabetic patients undergoing elective PCI with drug-eluting stents?
P
Population
674 non-diabetic patients undergoing elective percutaneous coronary intervention with drug-eluting stents, followed for 24 months to compare outcomes between prediabetic and normoglycemic groups.
E
Exposure
Prediabetes, defined as hemoglobin A1c (HbA1c) of 5.7% to 6.4% (n=242)
C
Comparator
Normoglycemia, defined as hemoglobin A1c (HbA1c) <5.7% (n=432)
O
Outcome
Incidence of MACE, defined as the composite of cardiovascular mortality, myocardial infarction (MI), or need for target vessel revascularization (TVR) within 24 months of the index PCI, adjudicated by a blinded experienced cardiovascular physiciancomposite
Main Result
Odds Ratio: 1.61 (95% CI 0.96–2.72)
Absolute Event Rate: 15.1% vs 10.2%
p-value: p=0.069
Prediabetes (HbA1c 5.7-6.4%) is an independent predictor of 2-year mortality in non-diabetic patients undergoing elective PCI with drug-eluting stents.
Limitations
- Non-randomized, single-center retrospective analysis introducing potential bias in patient and device selection
- Did not evaluate glucose metabolic function with an oral glucose tolerance test (OGTT)
- Routine angiographic follow-up was not performed, preventing analysis of absolute restenosis rates for the entire population
- non-randomized, single-center retrospective analysis
- did not evaluate glucose metabolic function with an OGTT
- routine angiographic follow-up was not performed
Authors
Discussion
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Implication
Prediabetes not linked to higher MACE after elective PCI; leaves open a mortality signal requiring prospective validation.
Cite This Study
Choi et al. (2018) conducted a cohort in Non-diabetic patients undergoing elective percutaneous coronary intervention (n=674). Prediabetes (HbA1c 5.7% to 6.4%) vs. Normoglycemia (HbA1c <5.7%) was evaluated on Major adverse cardiac events (composite of cardiovascular mortality, myocardial infarction, or target vessel revascularization) at 24 months (OR 1.61, 95% CI 0.96-2.72, p=0.069). Prediabetes was not associated with a statistically significant increase in the primary composite endpoint of major adverse cardiac events at 24 months compared to normoglycemia (15.1% vs. 10.2%, OR 1.61).
Topics
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