Hemoglobin A1c and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Baber, Usman; Azzalini, Lorenzo; Masoomi, Reza; Johal, Gurpreet; Barman, Nitin; Sweeny, Joseph; Ramanathan, Krishnan; Dangas, George; Vijay, Pooja; Jahveri, Vaishvi B.; Mehran, Roxana; Fuster, Valentı́n; Kini, Annapoorna; Sharma, Samin K.

doi:10.1016/j.jcin.2020.10.008

Cited by 19 publications

(7 citation statements)

References 16 publications

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“…Similarly, a meta-analysis of cardiovascular outcome trials revealed that intensive glycemic control was associated with a 9% reduction in the risk of MACE [26] . In a recent study evaluating patients with and without diabetes mellitus undergoing coronary artery revascularization, the risk for future myocardial infarction was increased in groups with greater HbA1c levels [27] . In addition, a recent large observational cohort of asymptomatic individuals without diabetes mellitus described a strong association between HbA1c and subclinical atherosclerosis, independent of potential confounders [28] .…”

Section: Discussionmentioning

confidence: 97%

HbA1c, Coronary atheroma progression and cardiovascular outcomes

Dykun

Bayturan

Carlo

et al. 2022

American Journal of Preventive Cardiology

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Section: Discussionmentioning

confidence: 97%

HbA1c, Coronary atheroma progression and cardiovascular outcomes

Dykun

Bayturan

Carlo

et al. 2022

American Journal of Preventive Cardiology

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“…35 Likewise, pre-procedural HbA1c displays a U-shape association with 1-year major adverse cardiac event risk in patients undergoing percutaneous coronary intervention (PCI). 12 Contrary to these, in the Veterans Affairs Diabetes Feasibility Trial, 36 a nonsignificant increase in cardiovascular events and no difference in mortality was observed in patients with intensive glucose-lowering therapy. In addition, researchers combined data from several trials and concluded that intensive glucose control has positive effects on cardiovascular events in two meta-analyses.…”

Section: Discussionmentioning

confidence: 94%

“…10 Therefore, both low and high HbA1c levels are associated with increased all-cause mortality and cardiac events. 7,11,12 Although several previous studies have analyzed the relationship between CAD and HbA1c, most of them are limited by the modest sample size. [13][14][15] Moreover, HbA1c is usually analyzed in a graded and linear manner, thereby failing to appreciate more complex nonlinear associations.…”

Section: Introductionmentioning

confidence: 99%

The association of glycated hemoglobin A1c with coronary artery disease, myocardial infarction, and severity of coronary lesions

Wei

Luan

et al. 2023

Journal of Investigative Medicine

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Glycated hemoglobin A1c (HbA1c) has been recognized as a predictor of cardiovascular events. However, the relationship between HbA1c and coronary artery disease (CAD) in the Chinese population has yet to be systematically explored. In addition, factors associated with HbA1c were generally analyzed linearly, thereby failing to appreciate more complex nonlinear associations. The study aimed to evaluate the relationship between the HbA1c value and the presence and severity of coronary artery stenosis. A total of 7192 consecutive patients who underwent coronary angiography were enrolled. Their biological parameters, including HbA1c, were measured. The severity of coronary stenosis was evaluated using Gensini score. After correcting for baseline confounding factors, a multivariate logistic regression analysis was used to evaluate the relationship between HbA1c and CAD severity. Restricted cubic splines were applied to explore the relation of HbA1c with the presence of CAD, myocardial infarction (MI), and the severity of coronary lesions. HbA1c was significantly associated with the presence and severity of CAD in patients without diagnosed diabetes (odds ratio: 1.306, 95% confidence interval: 1.053–1.619, p = 0.015). Spline analysis showed a U-shaped association of HbA1c with the presence of MI. Both HbA1c > 7.2% and HbA1c < 5.7% were associated with the presence of MI. In conclusion, HbA1c value was highly associated with the severity of coronary artery stenosis in the whole study population, and in CAD patients without diagnosed diabetes. Compared with patients with HbA1c levels between 6.0% and 7.0%, HbA1c < 5.7% and HbA1c > 7.2% were associated with higher presence of MI.

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“…Following the ESC guidelines, HbA1c targets should be individualised according to age and co-morbidities, although levels below < 7% should be pursued [ 25 ]. Furthermore, there is observational evidence that HbA1c levels > 8% before PCI are associated with a higher incidence of adverse cardiovascular events, in particular MI and target vessel revascularisation [ 87 ]. Treatment with extensive DAPT regimens after previous PCI yielded consistent beneficial results, irrespective of DM duration and HbA1c levels [ 88 ].…”

Section: Medical Treatment Strategiesmentioning

confidence: 99%

Exploring new insights in coronary lesion assessment and treatment in patients with diabetes mellitus: the impact of optical coherence tomography

Hommels

Hermanides

Fabris

et al. 2023

Cardiovasc Diabetol

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In this review, we summarise new insights into diagnostic approaches and treatment strategies for coronary artery disease (CAD) in patients with diabetes mellitus (DM). Despite the improvements in therapy, the clinical management of DM patients remains challenging as they develop more extensive CAD at a younger age and consistently have worse clinical outcomes than non-DM patients. Current diagnostic modalities as well as revascularisation treatments mainly focus on ischemic lesions. However, the impact of plaque morphology and composition are emerging as strong predictors of adverse cardiac events even in the absence of identified ischemia. In particular, the presence of vulnerable plaques such as thin-cap fibroatheroma (TCFA) lesions has been identified as a very strong predictor of future adverse events. This emphasises the need for an approach combining both functional and morphological methods in the assessment of lesions. In particular, optical coherence tomography (OCT) has proven to be a valuable asset by truly identifying TCFAs. New treatment strategies should consist of individualised and advanced medical regimens and may evolve towards plaque sealing through percutaneous treatment.

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Hemoglobin A1c and Cardiovascular Outcomes Following Percutaneous Coronary Intervention

Cited by 19 publications

References 16 publications

HbA1c, Coronary atheroma progression and cardiovascular outcomes

HbA1c, Coronary atheroma progression and cardiovascular outcomes

The association of glycated hemoglobin A1c with coronary artery disease, myocardial infarction, and severity of coronary lesions

Exploring new insights in coronary lesion assessment and treatment in patients with diabetes mellitus: the impact of optical coherence tomography

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