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).
Cohort (n=674)
No
Does prediabetes increase the risk of major adverse cardiac events and mortality in non-diabetic patients undergoing elective PCI with drug-eluting stents?
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.
Odds Ratio: 1.61 (95% CI 0.96–2.72)
Absolute Event Rate: 15.1% vs 10.2%
p-value: p=0.069
PURPOSE: Prediabetes is an independent risk factor for cardiovascular disease. However, data on the long term adverse clinical outcomes of prediabetic patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) are scarce. MATERIALS AND METHODS: The study population comprised 674 consecutive non-diabetic patients who underwent elective PCI between April 2007 and November 2010. Prediabetes was defined as hemoglobin A1c (HbA1c) of 5.7% to 6.4%. Two-year cumulative clinical outcomes of prediabetic patients (HbA1c of 5.7% to 6.4%, n=242) were compared with those of a normoglycemic group (<5.7%, n=432). RESULTS: Baseline clinical and angiographic characteristics were similar between the two groups, except for higher glucose levels (104.8±51.27 mg/dL vs. 131.0±47.22 mg/dL, p<0.001) on admission in the prediabetes group. There was no significant difference between the two groups in coronary angiographic parameters, except for a higher incidence of diffuse long lesion in the prediabetes group. For prediabetic patients, trends toward higher incidences of binary restenosis (15.6% vs. 9.8 %, p=0.066) and late loss (0.71±0.70 mm vs. 0.59±0.62 mm, p=0.076) were noted. During the 24 months of follow up, the incidence of mortality in prediabetic patients was higher than that in normoglycemic patients (5.5% vs. 1.5%, p=0.007). CONCLUSION: In our study, a higher death rate and a trend toward a higher incidence of restenosis in patients with prediabetes up to 2 years, compared to those in normoglycemic patients, undergoing elective PCI with contemporary DESs.
Choi et al. (Mon,) 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).