Diabetes significantly increased the risk of major adverse cardiovascular and cerebral endpoints compared to nondiabetes after coronary revascularization, with the excess risk being most profound in younger patients (HR 1.30 for ≤64 years).
Cohort (n=39,427)
Yes
Does diabetes increase the risk of MACCE in patients undergoing first coronary revascularization, and are there specific subgroups where this excess risk is more prominent?
The excess risk of adverse cardiovascular events associated with diabetes after coronary revascularization is particularly profound in younger patients, highlighting the need for aggressive secondary prevention in this demographic.
Absolute Event Rate: 27.4% vs 22.2%
p-value: p=<0.001
Background: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization. Objectives: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive interventions. Methods: The study population consisted of 39,427 patients (diabetes: n = 15,561; nondiabetes: n = 23,866) who underwent first percutaneous coronary intervention (n = 33,144) or coronary artery bypass graft (n = 6,283) in the pooled CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Graft) registry. The primary outcome measure was major adverse cardiovascular and cerebral endpoints (MACCE), which was defined as a composite of all-cause death, myocardial infarction, and stroke. Results: < 0.001), mainly driven by greater excess adjusted mortality risk of diabetes relative to nondiabetes in younger tertile. No significant interaction was observed between adjusted risk of diabetes relative to nondiabetes for MACCE and other subgroups such as sex, mode of revascularization, and clinical presentation of acute myocardial infarction. Conclusions: The excess risk of diabetes relative to nondiabetes for MACCE was profound in the younger population. This observation suggests more aggressive interventions for secondary prevention in patients with diabetes might be particularly relevant in younger patients.
Yamaji et al. (Tue,) conducted a cohort in Coronary artery disease requiring revascularization (n=39,427). Diabetes vs. Nondiabetes was evaluated on Major adverse cardiovascular and cerebral endpoints (MACCE) (p=<0.001). Diabetes significantly increased the risk of major adverse cardiovascular and cerebral endpoints compared to nondiabetes after coronary revascularization, with the excess risk being most profound in younger patients (HR 1.30 for ≤64 years).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: