Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization

David Hasdai, Robert A. Rizza, Diane E. Grill, Christopher G. Scott, Kirk N. Garratt, David Holmes

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: Our purpose was to examine whether the outcome of diabetic patients after successful percutaneous coronary revascularization (PCR) is influenced by the degree of control of hyperglycemia at the time of revascularization. Background: Diabetic patients have a worse outcome after PCR. Methods: We examined whether the degree of glycemic control (HbA 1c levels) affected the occurrence of all-cause death and death/myocardial infarction among diabetic patients after successful PCR from October 1979 through December 1998. HbA 1c was analyzed both as a continuous and a categorical variable (good [HbA 1c <8.0%, n = 700], moderate [8.0% < HbA 1c <10%, n = 442], or poor [HbA 1c >10%, n = 231] control). Results: HbA 1c levels were determined at a median (25th, 75th interquartiles) of 3 (1, 10) days after the index procedure for patients with good control, 2 (1, 7) days for moderate control, and 2 (1, 6) days for poor control. Median follow-up after successful PCR was 3.2 (1.2, 6.1) years, 3.9 (1.7,6.3) years, and 4.7 (2.1, 7.1) years, respectively. HbA 1c as a continuous variable did not have an impact on either death (hazard ratio [95% confidence interval] 1.04 [0.98-1.10]) or death/myocardial infarction (1.02 [0.98-1.07]). As a categorical variable, patients with moderate and poor control had a similar hazard of death (0.99 [0.78-1.26] and 1.14 [0.86-1.52], respectively) and death/myocardial infarction (1.01 [0.82-1.24] and 1.12 [0.87-1.45], respectively) relative to those with good control. Conclusions: The degree of glycemic control among diabetic patients at the time of their index intervention did not have an impact on long-term outcomes after successful PCR.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalAmerican Heart Journal
Volume141
Issue number1
DOIs
StatePublished - 2001

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Percutaneous Coronary Intervention
Myocardial Infarction
Hyperglycemia
Cause of Death
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization. / Hasdai, David; Rizza, Robert A.; Grill, Diane E.; Scott, Christopher G.; Garratt, Kirk N.; Holmes, David.

In: American Heart Journal, Vol. 141, No. 1, 2001, p. 117-123.

Research output: Contribution to journalArticle

Hasdai, David ; Rizza, Robert A. ; Grill, Diane E. ; Scott, Christopher G. ; Garratt, Kirk N. ; Holmes, David. / Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization. In: American Heart Journal. 2001 ; Vol. 141, No. 1. pp. 117-123.
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abstract = "Objective: Our purpose was to examine whether the outcome of diabetic patients after successful percutaneous coronary revascularization (PCR) is influenced by the degree of control of hyperglycemia at the time of revascularization. Background: Diabetic patients have a worse outcome after PCR. Methods: We examined whether the degree of glycemic control (HbA 1c levels) affected the occurrence of all-cause death and death/myocardial infarction among diabetic patients after successful PCR from October 1979 through December 1998. HbA 1c was analyzed both as a continuous and a categorical variable (good [HbA 1c <8.0{\%}, n = 700], moderate [8.0{\%} < HbA 1c <10{\%}, n = 442], or poor [HbA 1c >10{\%}, n = 231] control). Results: HbA 1c levels were determined at a median (25th, 75th interquartiles) of 3 (1, 10) days after the index procedure for patients with good control, 2 (1, 7) days for moderate control, and 2 (1, 6) days for poor control. Median follow-up after successful PCR was 3.2 (1.2, 6.1) years, 3.9 (1.7,6.3) years, and 4.7 (2.1, 7.1) years, respectively. HbA 1c as a continuous variable did not have an impact on either death (hazard ratio [95{\%} confidence interval] 1.04 [0.98-1.10]) or death/myocardial infarction (1.02 [0.98-1.07]). As a categorical variable, patients with moderate and poor control had a similar hazard of death (0.99 [0.78-1.26] and 1.14 [0.86-1.52], respectively) and death/myocardial infarction (1.01 [0.82-1.24] and 1.12 [0.87-1.45], respectively) relative to those with good control. Conclusions: The degree of glycemic control among diabetic patients at the time of their index intervention did not have an impact on long-term outcomes after successful PCR.",
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N2 - Objective: Our purpose was to examine whether the outcome of diabetic patients after successful percutaneous coronary revascularization (PCR) is influenced by the degree of control of hyperglycemia at the time of revascularization. Background: Diabetic patients have a worse outcome after PCR. Methods: We examined whether the degree of glycemic control (HbA 1c levels) affected the occurrence of all-cause death and death/myocardial infarction among diabetic patients after successful PCR from October 1979 through December 1998. HbA 1c was analyzed both as a continuous and a categorical variable (good [HbA 1c <8.0%, n = 700], moderate [8.0% < HbA 1c <10%, n = 442], or poor [HbA 1c >10%, n = 231] control). Results: HbA 1c levels were determined at a median (25th, 75th interquartiles) of 3 (1, 10) days after the index procedure for patients with good control, 2 (1, 7) days for moderate control, and 2 (1, 6) days for poor control. Median follow-up after successful PCR was 3.2 (1.2, 6.1) years, 3.9 (1.7,6.3) years, and 4.7 (2.1, 7.1) years, respectively. HbA 1c as a continuous variable did not have an impact on either death (hazard ratio [95% confidence interval] 1.04 [0.98-1.10]) or death/myocardial infarction (1.02 [0.98-1.07]). As a categorical variable, patients with moderate and poor control had a similar hazard of death (0.99 [0.78-1.26] and 1.14 [0.86-1.52], respectively) and death/myocardial infarction (1.01 [0.82-1.24] and 1.12 [0.87-1.45], respectively) relative to those with good control. Conclusions: The degree of glycemic control among diabetic patients at the time of their index intervention did not have an impact on long-term outcomes after successful PCR.

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