Key result
Low serum 1,5-anhydro-D-glucitol levels were independently associated with an increased risk of major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI (HR 0.980).
Why the study?
The association between serum 1,5-anhydro-D-glucitol levels and coronary artery calcification quantitatively assessed by optical coherence tomography was unclear.
Does low serum 1,5-anhydro-D-glucitol predict coronary artery calcification and major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI?
Cohort (n=256)
No
Does low serum 1,5-anhydro-D-glucitol predict coronary artery calcification and major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI?
Hazard Ratio: 0.98 (95% CI 0.961–1.001)
p-value: p=0.043
Low serum 1,5-AG levels are associated with increased coronary artery calcification and predict future major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI.
Background Serum 1,5-anhydro-D-glucitol (1,5-AG) is a novel biomarker for short-term glycemic status and postprandial hyperglycemia. The association between serum 1,5-AG levels and coronary artery calcification (CAC) through a quantitative assessment using optical coherence tomography (OCT) is unclear. We aimed to evaluate this association using OCT in patients with diabetes mellitus (DM). Methods From June 2016 to December 2019, we prospectively enrolled 256 patients who underwent OCT-guided percutaneous coronary intervention (PCI). Half of the patients had diabetes. Patients were followed up for a mean period of 1.8 ± 0.8 years (median: 2.2 years). The relative calcium index and relative lipid core index measured by quantitative OCT analysis were used to evaluate the intra-plaque calcium and lipid levels of culprit plaques. We also analyzed the correlation between serum 1,5-AG levels and long-term major adverse cardiovascular events. Results Serum 1,5-AG levels were significantly lower in diabetic patients than in non-diabetic patients (DM vs. non-DM: 55.6 ± 27.9 μg/mL vs. 63.7 ± 26.1 μg/mL, p = 0.016), and lower in fibrocalcified lesions than in fibrotic or fibrolipidic lesions (fibrocalcified vs. fibrotic or fibrolipidic: 42.8 ± 19.1 vs. 72.9 ± 25.2 or 66.4 ± 27.5 μg/mL, p < 0.001, respectively). In addition, we found a significant inverse correlation between serum 1,5-AG levels and relative calcium index ( r = −0.729, p < 0.001). In multivariate Cox regression analysis, low serum 1,5-AG level was identified as an independent predictor for major adverse cardiovascular events in diabetic patients ( p = 0.043), but not in non-diabetic patients ( p = 0.748) after adjusting for age and sex. Conclusion This study revealed that low serum 1,5-AG levels were associated with an increased risk of CAC as assessed by OCT, especially in diabetic patients. Low serum 1,5-AG levels may predict future major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI.
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Teng et al. (2022) conducted a cohort in Coronary artery disease (n=256). Serum 1,5-anhydro-D-glucitol (1,5-AG) levels vs. Higher serum 1,5-AG levels was evaluated on Major adverse cardiovascular events (MACE) in diabetic patients (HR 0.980, 95% CI 0.961-1.001, p=0.043). Low serum 1,5-anhydro-D-glucitol levels were independently associated with an increased risk of major adverse cardiovascular events in diabetic patients undergoing OCT-guided PCI (HR 0.980).
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