TY - JOUR
T1 - Prospective Study of the Impact of Diabetes Mellitus Newly Diagnosed by Glycated Hemoglobin on Outcomes in Patients Undergoing Percutaneous Coronary Intervention
AU - Abu Tailakh, Muhammad
AU - Friger, Michael
AU - Zahger, Doron
AU - Sidi, Aviel
AU - Mazor-Dray, Efrat
AU - Novack, Victor
N1 - Publisher Copyright:
© 2016 European Federation of Internal Medicine.
PY - 2017
Y1 - 2017
N2 - Background We sought to determine the prevalence of diabetes mellitus (DM) newly diagnosed by elevated glycated hemoglobin (HbA1c) in patients undergoing percutaneous coronary intervention (PCI) and its association with 1-year clinical outcomes. Methods We prospectively enrolled consecutive patients undergoing PCI (2011–2013). HbA1c levels were assessed during the index hospitalization and newly diagnosed DM was defined as HbA1c ≥ 6.5% in the absence of the previous diagnosis. The primary outcome was MACCE (Major Adverse Cerebro- and Cardiovascular Events) defined as death, stroke, PCI or acute myocardial infarction at 1 year. Results Diabetes was previously diagnosed in 391 (34%) patients (DM group), 221 (19%) had newly diagnosed DM based on the HbA1c level and 539 (47%) did not have diabetes (Non-DM). In DM group HbA1c was 7.80 ± 1.36% as compared with 7.62 ± 1.30% in patients with newly diagnosed DM (p < 0.001). These patients were younger (62.0 ± 11.3 years) compared to DM (67.9 ± 10.4 years) and non-DM (63.7 ± 13.0) patients, p < 0.001. 1-year MACCE rates were 14.8%, 19.5% and 27.96% in the non-DM, newly diagnosed DM and DM groups, respectively (p < 0.001). Multivariate analysis showed that compared to non-DM, the adjusted one-year hazard ratios for MACCE were 1.75 and 1.40 in patients with known DM and newly diagnosed DM, respectively (p < 0.05 for both). Conclusion Newly diagnosed DM based on peri-procedural HbA1c is common and associated with increased short and long term risk for adverse outcomes. Our results may warrant routine screening for DM in all patients undergoing PCI.
AB - Background We sought to determine the prevalence of diabetes mellitus (DM) newly diagnosed by elevated glycated hemoglobin (HbA1c) in patients undergoing percutaneous coronary intervention (PCI) and its association with 1-year clinical outcomes. Methods We prospectively enrolled consecutive patients undergoing PCI (2011–2013). HbA1c levels were assessed during the index hospitalization and newly diagnosed DM was defined as HbA1c ≥ 6.5% in the absence of the previous diagnosis. The primary outcome was MACCE (Major Adverse Cerebro- and Cardiovascular Events) defined as death, stroke, PCI or acute myocardial infarction at 1 year. Results Diabetes was previously diagnosed in 391 (34%) patients (DM group), 221 (19%) had newly diagnosed DM based on the HbA1c level and 539 (47%) did not have diabetes (Non-DM). In DM group HbA1c was 7.80 ± 1.36% as compared with 7.62 ± 1.30% in patients with newly diagnosed DM (p < 0.001). These patients were younger (62.0 ± 11.3 years) compared to DM (67.9 ± 10.4 years) and non-DM (63.7 ± 13.0) patients, p < 0.001. 1-year MACCE rates were 14.8%, 19.5% and 27.96% in the non-DM, newly diagnosed DM and DM groups, respectively (p < 0.001). Multivariate analysis showed that compared to non-DM, the adjusted one-year hazard ratios for MACCE were 1.75 and 1.40 in patients with known DM and newly diagnosed DM, respectively (p < 0.05 for both). Conclusion Newly diagnosed DM based on peri-procedural HbA1c is common and associated with increased short and long term risk for adverse outcomes. Our results may warrant routine screening for DM in all patients undergoing PCI.
KW - Diabetes mellitus
KW - HbA1c
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=84994544665&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2016.09.007
DO - 10.1016/j.ejim.2016.09.007
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C2 - 27665509
AN - SCOPUS:84994544665
VL - 37
SP - 69
EP - 74
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
ER -