Impact of post-challenge hyperglycemia on clinical outcomes in japanese patients with stable angina undergoing percutaneous coronary intervention

Shoichi Kuramitsu, Hiroyoshi Yokoi, Takenori Domei, Akihiro Nomura, Hirotoshi Watanabe, Kyohei Yamaji, Yoshimitsu Soga, Takeshi Arita, Katsuhiro Kondo, Shinichi Shirai, Kenji Ando, Koyu Sakai, Masashi Iwabuchi, Hedeyuki Nosaka, Masakiyo Nobuyoshi

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Abstract

Background: Post-challenge hyperglycemia (PH) is well-established as one of risk factors for coronary artery disease. However, it remains unclear whether PH affects clinical outcomes in patients with stable angina undergoing percutaneous coronary intervention (PCI).Methods: A total of 828 patients with stable angina undergoing PCI were retrospectively analyzed. Of these, 452 patients with previously diagnosed diabetes mellitus (DM) or fasting plasma glucose (PG) ≥126 mg/dl and HbA1c ≥6.5% were defined as known DM. The remaining 376 patients were divided into the two groups according to 2-h PG: PH (2-h PG ≥140 mg/dl, n=236) and normal glucose tolerance (NGT, 2-h PG <140 mg/dl, n=140). We assessed the rate of major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, and clinically-driven revascularization.Results: During the median follow-up of 4.3 years, the MACE rate was significantly higher in the DM and PH groups than the NGT group (39.3% vs. 20.7%, P <0.001; 31.4% vs. 20.7%, P=0.044, respectively). Compared with the NGT group, the cumulative incidence of revascularization was significantly higher in the DM group (35.1% vs. 18.5%, P <0.001) and tended to be higher in the PH group (27.1% vs. 18.5%, P=0.067). In the multivariate analysis, known DM (Hazard ratio [HR]: 2.16, 95% confidence interval (CI): 1.49-3.27, P < 0.001), PH (HR: 1.62, 95% CI: 1.07-2.53, P = 0.023), LDL-C >100 mg/dl (HR: 1.62, 95% CI: 1.26 to 2.10, P < 0.001), and previous stroke (HR: 1.47, 95% CI: 1.03-2.04, P = 0.034) were predictors of MACE.Conclusion: PH is associated with future cardiovascular events in patients with stable angina undergoing PCI.

Original languageEnglish
Article number74
JournalCardiovascular Diabetology
Volume12
Issue number1
DOIs
Publication statusPublished - May 7 2013

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All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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