OBJECTIVES: We examined the association between glycemic control determined by preprocedural hemoglobin A1c (A1c) and the incidence of target vessel revascularization (TVR) in diabetic patients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND: Patients with diabetes mellitus (DM) have increased rates of restenosis and a worse clinical outcome after PCI than patients without DM. METHODS: A total of 239 patients (60 without DM and 179 with DM) were enrolled in this study. Optimal glycemic control was defined as A1c < or =7%, and suboptimal control was defined as A1c >7%. Follow-up was performed at six and 12 months after the index intervention. RESULTS: Diabetic patients with optimal glycemic control had a rate of 12-month TVR similar to that of nondiabetic patients (15% vs. 18%, p = NS). Diabetic patients with A1c >7% had a significantly higher rate of TVR than those with A1c <7% (34% vs. 15%, p = 0.02). In a multiple logistic regression analysis, A1c >7% was a significant independent predictor of TVR (odds ratio 2.87, 95% confidence interval 1.13 to 7.24; p = 0.03). Optimal glycemic control was associated with a lower rate of cardiac rehospitalization (15% vs. 31%, p = 0.03) and recurrent angina (13% vs. 37%, p = 0.002) at 12-month follow-up. CONCLUSIONS: In diabetic patients undergoing elective PCI, optimal glycemic control (A1c < or =7%) is associated with a lower rate of TVR, cardiac rehospitalization, and recurrent angina. These data suggest that aggressive treatment of DM to achieve A1c < or =7% is beneficial in improving the clinical outcome after PCI.
OBJECTIVES: We examined the association between glycemic control determined by preprocedural hemoglobin A1c (A1c) and the incidence of target vessel revascularization (TVR) in diabeticpatients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND:Patients with diabetes mellitus (DM) have increased rates of restenosis and a worse clinical outcome after PCI than patients without DM. METHODS: A total of 239 patients (60 without DM and 179 with DM) were enrolled in this study. Optimal glycemic control was defined as A1c < or =7%, and suboptimal control was defined as A1c >7%. Follow-up was performed at six and 12 months after the index intervention. RESULTS:Diabeticpatients with optimal glycemic control had a rate of 12-month TVR similar to that of nondiabeticpatients (15% vs. 18%, p = NS). Diabeticpatients with A1c >7% had a significantly higher rate of TVR than those with A1c <7% (34% vs. 15%, p = 0.02). In a multiple logistic regression analysis, A1c >7% was a significant independent predictor of TVR (odds ratio 2.87, 95% confidence interval 1.13 to 7.24; p = 0.03). Optimal glycemic control was associated with a lower rate of cardiac rehospitalization (15% vs. 31%, p = 0.03) and recurrent angina (13% vs. 37%, p = 0.002) at 12-month follow-up. CONCLUSIONS: In diabeticpatients undergoing elective PCI, optimal glycemic control (A1c < or =7%) is associated with a lower rate of TVR, cardiac rehospitalization, and recurrent angina. These data suggest that aggressive treatment of DM to achieve A1c < or =7% is beneficial in improving the clinical outcome after PCI.
Authors: Amy B Kauffman; Thomas Delate; Kari L Olson; Alicia A Cymbala; Kara A Hutka; Sheila L Kasten; Jon R Rasmussen Journal: Clin Drug Investig Date: 2008 Impact factor: 2.859
Authors: Binita Shah; Jeffrey S Berger; Nicholas S Amoroso; Xingchen Mai; Jeffrey D Lorin; Ann Danoff; Arthur Z Schwartzbard; Iryna Lobach; Yu Guo; Frederick Feit; James Slater; Michael J Attubato; Steven P Sedlis Journal: Am J Cardiol Date: 2014-02-12 Impact factor: 2.778
Authors: Satinder Singh; Ehrin J Armstrong; Walid Sherif; Bejan Alvandi; Gregory G Westin; Gagan D Singh; Ezra A Amsterdam; John R Laird Journal: Vasc Med Date: 2014-06-17 Impact factor: 3.239