Key result
In patients with stable CAD undergoing PCI, the combination of hypercholesterolemia and diabetes was associated with the highest risk of all-cause mortality (HR 1.70; P<0.01).
Why the study?
The effect of hypercholesterolemia and diabetes on long-term outcomes in patients with stable CAD receiving PCI was unclear.
Does the presence of hypercholesterolemia and diabetes worsen long-term outcomes in patients with stable coronary artery disease receiving percutaneous coronary intervention?
Cohort (n=1,676)
Does the presence of hypercholesterolemia and diabetes worsen long-term outcomes in patients with stable coronary artery disease receiving percutaneous coronary intervention?
Hazard Ratio: 1.7
p-value: p=< .01
Diabetes, with or without hypercholesterolemia, adversely impacts long-term outcomes in patients with stable CAD receiving PCI, with an additive effect on all-cause mortality when both conditions are present.
Diabetes plus hypercholesterolemia signals highest post-PCI mortality risk; hypothesis-generating for targeted trials before practice change.
Coronary artery disease (CAD) is a life-threatening medical emergency which needs urgent medical attention. Percutaneous coronary intervention (PCI) is common and necessary for patients with CAD. The effect of hypercholesterolemia and diabetes on long-term outcomes in patients with stable CAD receiving PCI is unclear.In this study, patients with stable CAD who underwent PCI were prospectively divided into 4 groups according to the presence or absence of diabetes or hypercholesterolemia. Clinical characteristics, risk factors, medications, angiographic findings, and outcome predictors were analyzed and long-term outcomes compared between groups.Of the 1676 patients studied, those with hypercholesterolemia and diabetes had the highest all-cause mortality rate after PCI (P < .01); those with diabetes only had the highest cardiovascular (CV) mortality (P < .01). However, the 4 groups did not differ in rates of myocardial infarction (MI) or repeated PCI. In Kaplan-Meier survival analysis, patients with diabetes only had the highest rates of all-cause mortality and CV mortality (both P < .001). In the Cox proportional hazard model, patients with both hypercholesterolemia and diabetes had the highest risk of all-cause mortality (hazard ratio: 1.70), but groups did not differ in rates of MI, CV mortality, and repeated PCI.With or without hypercholesterolemia, diabetes adversely impacts long-term outcomes in patients receiving PCI. Diabetes mellitus seemed to be a more hazardous outcome predictor than hypercholesterolemia. Hypercholesterolemia and diabetes seemed to have an additive effect on all-cause mortality in patients after receiving PCI.
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Lin et al. (2019) conducted a cohort in Stable coronary artery disease receiving percutaneous coronary intervention (n=1,676). Hypercholesterolemia and diabetes vs. Absence of diabetes and/or hypercholesterolemia was evaluated on All-cause mortality (HR 1.70, p=< .01). In patients with stable CAD undergoing PCI, the combination of hypercholesterolemia and diabetes was associated with the highest risk of all-cause mortality (HR 1.70; P<0.01).
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