Prognostic Value of Hemoglobin A1C Levels in Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention With Stent Implantation

• Published in: The American journal of cardiology 2009-07, Vol.104 (1), p.41-45
• Main Authors: Lemesle, Gilles, MD, Bonello, Laurent, MD, de Labriolle, Axel, MD, Maluenda, Gabriel, MD, Syed, Asmir I., MD, Collins, Sara D., MD, Ben-Dor, Itsik, MD, Torguson, Rebecca, MPH, Kaneshige, Kimberly, BS, Xue, Zhenyi, MS, Suddath, William O., MD, Satler, Lowell F., MD, Kent, Kenneth M., MD, PhD, Lindsay, Joseph, MD, Pichard, Augusto D., MD, Waksman, Ron, MD
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cohort Studies; Comparative analysis; Confidence Intervals; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Diabetes; Diabetes Complications - blood; Diabetes Complications - mortality; Diabetes. Impaired glucose tolerance; Diseases of the cardiovascular system; Drug-Eluting Stents; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glycated Hemoglobin A - analysis; Hemoglobin; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Prognosis; Proportional Hazards Models; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Retrospective Studies; Stents; Studies
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.02.060

The optimal glycosylated hemoglobin (HbA1C) target in diabetic patients is a subject of ongoing controversy that may be especially pertinent in diabetic patients with coronary artery disease. This study aimed to determine the prognostic value of preprocedural HbA1C levels in diabetic patients undergoing percutaneous coronary intervention (PCI) with stent implantation. From 2002 to 2007, a cohort of 952 consecutive diabetic patients underwent PCI with stent implantation in our center. We compared patients with a normal preprocedural HbA1C (≤ 7%, n = 429) with patients with an increased HbA1C (>7%, n = 523). One-year rate of major adverse cardiovascular events (MACEs) including death, myocardial infarction, and target vessel revascularization was indexed. Baseline characteristics were similar between groups, except for body mass index, which was higher in the high HbA1C group (32.2 vs 31.2 kg/m2 , p = 0.03). Patients in the high HbA1C group were more likely insulin dependent (45.5% vs 26.3%, p