The impact of diabetes mellitus and hypertension on clinical outcomes in a population of Iranian patients who underwent percutaneous coronary intervention: A retrospective cohort study

Abstract

There are heterogeneous data regarding the impact of diabetes mellitus (DM) and hypertension (HTN) on clinical outcomes after percutaneous coronary intervention (PCI). This study explored the effect of history of DM (hDM) and HTN (hHTN), separately and in combination with each other, on major adverse cardiac events (MACE) in short‐, mid‐, and long‐term intervals after PCI. Between 2000 and 2017, 1799 patients who had PCI were registered. They were categorized in four different groups: hDM, hHTN, hDM + hHTN, and no hDMQuery no hHTN. Incidence of myocardial infarction, revascularization, and coronary death totally considered as MACE was sought in short‐ (<24 hours), mid‐ (24 hours up to 6 months), and long‐term (more than 6 months) intervals after PCI. Among the subjects, 176 had hDM, 648 had hHTN, 370 had hDM + hHTN, and 605 were in no hDM no hHTN group. The median follow‐up time was 66.5 months. Time‐to‐event (time to the first MACE) was not significantly different between four groups. hHTN group was older and hDM group was younger at the time of enrollment PCI. Female gender was dominant only in hDM + hHTN group. Of the total, 130 patients (7.22%) experienced MACE. There was no MACE in short term, 23.07% of the MACEs were in mid‐term, and the remaining happened in long term. However, according to the rate ratio, incidence rate of MACE in mid‐tem was significantly higher than the long term. Also, MACE occurrence was significantly higher in hDM + hHTN and hHTN groups than the no hDM no hHTN group. Our study showed that the history of HTN significantly increases post‐PCI MACE rather than the history of DM. Having history of both DM and HTN synergistically raised MACE incidence. Incidence of MACE per month was higher in mid‐term than the long‐term interval.

Primary percutaneous coronary intervention in CAD patients: A comparison of major adverse cardiovascular events of second- and third-generation drug-eluting stents

“…BP-SES and DP-EES were compared in diabetic patients, and results concluded that BP stents were associated with more TLR than DP stents in diabetic people ( Kakizaki et al, 2020 ). The percentage of MACE was more in DM and hypertensive patients at a follow-up of 66.5 months, and the combined effect of DM and HTN increased the incidence of MACEs further ( Zibaeenezhad et al, 2019 ).…”

“…The study consisted of two phases: a retrospective phase (in which data were retrieved from the hospital record) and a prospective phase (follow-up of patients at 1 year duration, post-PCI). The major adverse cardiovascular events are defined as the composite endpoints of non-fatal MI, stent thrombosis, clinically driven TVR/TLR, and cardiovascular death ( Zibaeenezhad et al, 2019 ). The XIENCE Xpedition Everolimus-Eluting Stent (EES) having a cobalt chromium strut loaded with 100 µg/cm 2 everolimus and XIENCE Prime (Abbott) is also a 100 µg/cm 2 everolimus-coated stent ( Abbott, 2013 ; Abbott, 2015 ).…”

“…As compared to other ethnic groups, the people of South Asia are more prone to the development of atherosclerosis and thus have a high mortality rate ( Nadeem et al, 2013 ). In the treatment of patients with CAD, major goals are to decrease the incidence of major adverse cardiac events (MACEs) that includes the composite of all-cause death, stent thrombosis (ST), myocardial infarction (MI), target lesion/vessel revascularization (TLR/TVR), and restenosis; improve symptoms, quality of life (QoL), and functional status; and to prolong life ( Adnan et al, 2017 ; Zibaeenezhad et al, 2019 ).…”

The Impact of Smoking on Clinical Outcomes after Percutaneous Coronary Intervention in Women Compared to Men

“…Patients who had fasting plasma glucose of ≥126 mg/dL (7.0 mmol/L) or 2 h plasma glucose of ≥200 mg/ dL (11.1 mmol/L) during oral glucose tolerance test or A1C of ≥6.5% (48 mmol/mol) or with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose of ≥200 mg/dL (11.1 mmol/L), or receiving antihyperglycemic medications before index PCI were considered as having diabetes mellitus (DM). Patients who had systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg or both or receiving antihypertensive medications before index PCI were considered as having hypertension (HTN) [9].…”

Can anthropometric indices predict the chance of hypertension? A multicentre cross-sectional study in Iran

“…14 Diabetes mellitus, as a risk factor for HTN, causes significantly worse major adverse cardiac events following percutaneous coronary intervention. 15 16 …”