Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention

Abstract

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.

Glycosylated Hemoglobin Is a Predictor of Major Adverse Cardiac Events after Drug-Eluting Stent Implantation in Patients with Diabetes Mellitus

“…Although several studies have been reported on the relationship between glycemic control and outcomes after PCI in diabetic patients [6,13,14], it remains controversial. Hasdai et al [13] showed that the degree of glycemic control among diabetic patients did not have an impact on long-term outcomes after percutaneous coronary revascularization.…”

“…Hasdai et al [13] showed that the degree of glycemic control among diabetic patients did not have an impact on long-term outcomes after percutaneous coronary revascularization. Corpus et al [6] reported that optimal glycemic control was associated with a lower rate of TVR in diabetic patients undergoing PCI, and suggested that the aggressive treatment of diabetes mellitus was beneficial in improving the clinical outcome after PCI. Lemesle et al [14] reported that hemoglobin A1c was not a predictor of cardiac events after PCI with stent implantation.…”

“…More than half of the patients underwent balloon angioplasty alone. Corpus et al [6] defined the primary end point as the need for TVR, and secondary end points as cardiac death, myocardial infarction, recurrent angina, stroke, congestive heart failure, renal failure, and cardiac rehospitalization. Lemesle et al [14] defined the primary end point as death, myocardial infarction, and TVR at 1-year follow-up.…”

“…Several studies have demonstrated that hemoglobin A1c is related to cardiovascular disease and mortality [3,4,5]. In addition, hemoglobin A1c has been associated with target vessel revascularization (TVR) after percutaneous coronary intervention (PCI) [6]. …”

Management of diabetes in cardiovascular patients

“…Glucose control is also an important factor in determining outcome following coronary intervention in people with diabetes. Corpus et al 10 studied 60 patients with diabetes and 179 patients without diabetes undergoing elective percutaneous coronary intervention. At 12 months, patients with diabetes and HbA1c >7% had a significantly higher rate of target vessel revascularisation compared with patients with diabetes and HbA1c <7% (34% vs 15%; p = 0.02).…”