“Silent” Diabetes and Clinical Outcome After Treatment With Contemporary Drug-Eluting Stents

Birgelen, Clemens von; Kok, Marlies M.; Sattar, Naveed; Zocca, Paolo; Doelman, C. J. A.; Kant, Gert; Löwik, Marije M.; Heijden, Liefke C. van der; Sen, Hanim; Houwelingen, K. Gert van; Stoel, Martin G.; Louwerenburg, J. W.; Hartmann, Marc; Man, Frits H.A.F. de; Linssen, Gerard C.M.; Doggen, Carine J.M.; Tandjung, Kenneth

doi:10.1016/j.jcin.2017.10.038

Cited by 26 publications

(31 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…encouraging patients to engage in local activities which can help them to improve their health problems and/or reducing their concerns about medication/chronic illness). Moreover, reinforcing positive patient beliefs in the need for medication is particularly important for "silent" chronic conditions, such as diabetes and HIV infection 24,25 . The use of good, targeted information to reduce patients' concerns about medications, and close supervision from the clinical team to promote patient selfmanagement, may be particularly beneficial in such conditions.…”

Section: Discussionmentioning

confidence: 99%

Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

Cea‐Calvo

Marín-Jiménez

Toro

et al. 2019

Current Medical Research and Opinion

View full text Add to dashboard Cite

Objective: The objective of the current work was to assess the frequency of non-adherence behaviors and potential association with patients' experience with healthcare and beliefs in medicines selfreported by patients with four different chronic conditions. Methods: Patients responded anonymously to a survey comprising five non-adherence behaviors (based on physician and patient input), an assessment of patients' experience with healthcare using the validated Instrument to Evaluate the EXperience of PAtients with Chronic diseases (IEXPAC), and a validated Spanish version of the Beliefs about Medicines Questionnaire (BMQ). Associations of nonadherence behavior were analyzed using logistic regression models. Results: Of 1530 respondents, 53.1% reported !1 non-adherence behavior. Non-adherence rates were 59.8% in diabetes mellitus (DM), 56.0% in rheumatic disease, 55.6% in inflammatory bowel disease, and 42.8% in human immunodeficiency virus (HIV) infection patients (p < .001). IEXPAC and BMQ scores were higher in adherent vs. non-adherent patients. In multivariate analysis, non-adherence behavior was strongly associated with lower overall BMQ, lower BMQ Necessity scores and higher BMQ Concerns scores (p < .001 for all), and with a lower IEXPAC self-management score (p ¼ .007), but not with the overall IEXPAC score. Non-adherence was more frequent in DM patients compared with HIV infection patients (p < .001). Conclusions: Patients' beliefs in medicines-a lower perception for the necessity of medication, and higher concerns in taking medication-and low patient self-management experience score were associated with non-adherence behavior. These are modifiable aspects that need to be addressed to increase medication adherence in chronic disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

Cea‐Calvo

Marín-Jiménez

Toro

et al. 2019

Current Medical Research and Opinion

View full text Add to dashboard Cite

show abstract

“…Of them, sixteen were further excluded because one of them was not a follow-up study, six did not include patients that underwent PCI, four did not report MACE outcome, four were without available outcome data, and the other one did not include controls with normoglycemia. Finally, twelve follow-up studies were included [12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: Results Of Literature Searchmentioning

confidence: 99%

“…Forest plots for the meta-analysis of the incidence of MACE in patients with prediabetes compared to those with normoglycemia after PCI [12,15,16,18], retrospective cohort [13,14,17,18,20] or post-hoc analyses of the randomized controlled trials (RCTs) [21][22][23]. Two studies included patients with stable CAD [12,17], five studies included only patients with ST-segment elevation myocardial infarction (STEMI) [13,14,16,18,19], one with acute coronary syndrome (ACS) [23], while the other included a broad patients with CAD [20][21][22]. Primary PCI was applied in five studies [13,14,16,18,19], and elective PCI was applied in four studies [12,15,17,20].…”

Section: Study Characteristics and Quality Evaluationmentioning

confidence: 99%

“…Primary PCI was applied in five studies [13,14,16,18,19], and elective PCI was applied in four studies [12,15,17,20]. A total of 3368 patients were with prediabetes at admission, as defined by the criteria with IFG and/or IGT in seven studies [12][13][14][15][16][17]22], with HbA1c in three studies [18][19][20], and IFG and/or HbA1c in two studies [21,23]. The mean age of the included CAD patients varied from 57.2 to 67.8 years, with proportions of male patients ranging from 66.5 to 85.8%.…”

Section: Study Characteristics and Quality Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Prediabetes predicts adverse cardiovascular outcomes after percutaneous coronary intervention: a meta-analysis

Zhao

Guo²,

Shi

2020

Bioscience Reports

View full text Add to dashboard Cite

Background: Prediabetes has been related with increased risk of coronary artery disease (CAD). However, the prognostic efficacy of prediabetes for patients receiving percutaneous coronary intervention (PCI) remains undetermined. We aimed to quantitatively evaluate the influence of diabetes on the risks of major adverse cardiovascular events (MACEs) after PCI in a meta-analysis. Methods: Longitudinal follow-up studies evaluating the association between prediabetes and risks of MACEs and mortality after PCI were identified by search of PubMed and Embase databases. A random-effect model was applied to pool the results. Subgroup analyses were performed to evaluate the impacts of study characteristics on the outcome. Results: Twelve follow-up studies including 10,048 patients that underwent PCI were included. Compared with patients with normoglycemia at admission, those with prediabetes were had significantly higher risk MACEs during follow-up (adjusted risk ratio [RR]: 1.53, 95% confidence interval [CI]: 1.25–1.87, P < 0.001). Further subgroup analyses indicated that the association between prediabetes and higher risk of MACEs remained regardless of the study design, sample size, CAD subtype, PCI type, definition of diabetes, or follow-up duration. Moreover, patients with prediabetes had higher significantly risk of MACEs in studies with adjustment of coronary lesion severity (RR: 1.79, P < 0.001), but the association became insignificant in studies without adjustment of the coronary lesion severity (RR: 1.23, P = 0.09). Conclusions: Prediabetes is independently associated with increased risk of MACEs after PCI as compared with those with normoglycemia, even in studies with adjustment of coronary severity.

show abstract

“…Recent reports [20,21] also showed that the patency of the IRA in patients with STEMI was related to procedural success and decreased enzymatic infarct size, fatal arrhythmic events, and in-hospital mortality. Because recent studies [5][6][7] did not use TIMI ow grade as a variable in estimating the clinical outcomes between these two groups, we considered that the TIMI ow grade can be used as a meaningful variable for the comparison of major clinical outcomes between prediabetes and T2DM.…”

Section: Discussionmentioning

confidence: 99%

Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Kim

Her

Jeong

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Studies comparing long-term clinical outcomes between prediabetes and diabetes based on pre-percutaneous coronary intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grade in patients with ST-segment elevation myocardial infarction (STEMI) after successful PCI with newer-generation drug-eluting stents are limited. We compared 2-year clinical outcomes of these two groups. Methods: Overall, 6448 STEMI patients were divided into two groups: pre-PCI TIMI 0/1 group (n = 4854) and pre-PCI TIMI 2/3 group (n = 1594). Subsequently, these two groups were further divided into patients with normoglycemia, prediabetes, and type 2 diabetes mellitus (T2DM). The major endpoint was the occurrence of major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction, or any repeat revascularization. Results: After adjustment, in the pre-PCI TIMI 0/1 group, the cumulative incidence of all-cause death was higher in both prediabetes (adjusted hazard ratio [aHR]: 1.633, p = 0.045) and T2DM (aHR: 2.064, p = 0.002) groups than in the normoglycemia group. In the pre-PCI TIMI 2/3 group, the cumulative incidence of any repeat revascularization was higher in both prediabetes (aHR: 2.511, p = 0.039) and T2DM (aHR: 3.156, p = 0.009) groups than in the normoglycemia group. However, in each group (pre-PCI TIMI 0/1 or 2/3), the cumulative incidences of MACEs and all other clinical outcomes were not significantly different between the prediabetes and T2DM groups. Conclusions: In this retrospective registry study, prediabetes showed worse clinical outcomes similar to those of T2DM regardless of the pre-PCI TIMI flow grade. However, further studies are warranted to confirm these results.

show abstract

“Silent” Diabetes and Clinical Outcome After Treatment With Contemporary Drug-Eluting Stents

Abstract: Abnormal glucose metabolism was detected in 1 of 3 "nondiabetic" PCI patients and was independently associated with up to 4-fold higher event risks. Future intervention trials should determine whether meaningful benefits accrue from routine glycemia testing in such patients.

Cited by 26 publications

References 35 publications

Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions

Prediabetes predicts adverse cardiovascular outcomes after percutaneous coronary intervention: a meta-analysis

Impact of Pre-percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade in Patients With ST-segment Elevation Myocardial Infarction and Prediabetes or Diabetes After Successful Newer-generation Drug-eluting Stent Implantation

Contact Info

Product

Resources

About