Prediabetes and coronary artery disease: Outcome after revascularization procedures

Abstract

Objective: To assess the long-term association between prediabetes and an increased risk of cardiovascular events in patients with coronary artery disease and percutaneous coronary intervention (PCI).

Methods: A retrospective cohort study. We searched our database to identify all PCI procedures performed in 2010. Patients with no diabetes and HbA1c measurement in the index hospitalization were enrolled and divided into two groups based on HbA1c value: 5.7-6.5% for prediabetes and <5.7% for controls. Demographic, clinical, and procedure-related variables were recorded. Study endpoints were mortality, hospital admissions, myocardial infarction (MI), and revascularization procedures.

Results: The study population consisted of 132 subjects (82.6% males, age: 65.26 ± 12.46 years). No difference was found as regards distribution of demographic, clinical, and procedure-related variables. A majority (64.1%) of PCI procedures were performed for ST-segment elevation MI. Prevalence of prediabetes was 40.2%. After a mean follow-up period of 42.3 ± 3.6 months, no differences were found in outcomes between the prediabetes and control groups in total mortality (5.4% vs 1.9%; relative risk [RR] 2.86, 95% confidence interval [95% CI] 0.27-30.44; P=.56), non-cardiovascular mortality (2.7% vs 1.9%; RR 1.43, 95% CI 0.93-22.18; P=.79), hospital admissions (19% vs 25%; RR 1.13, 95%CI 0.73-1.73; P=.57), MI (3% vs 1%; RR 4.28, 95%CI .46-39.52; P=.30), or target lesion revascularization (3% vs 6%); RR .70, 95%CI .18-2.61; P=.72).

Conclusions: Prediabetes, as determined by HbA1c (5.7%-6.5%), is not associated with long-term adverse cardiovascular outcomes in patients with CAD and PCI.

Keywords: Acute coronary syndrome; Coronary artery disease; Intervencionismo coronario percutáneo; Myocardial Revascularization; Prediabetes; Revascularización coronaria; Síndrome coronario agudo.