Title:Prognostic Significance of Relative Hyperglycemia after Percutaneous Coronary Intervention in Patients with and without Recognized Diabetes
VOLUME: 19 ISSUE: 1
Author(s):Qi Zhao, Ting-Yu Zhang , Yu-Jing Cheng, Yue Ma, Ying-Kai Xu , Jia-Qi Yang and Yu-Jie Zhou*
Affiliation:Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, Research Center for Coronary Heart Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029
Keywords:Non-ST-segment elevation, acute coronary syndrome, percutaneous coronary intervention, post-procedural glycemic
index, hyperglycemia, diabetes.
Abstract:
Background: The research on the association between the relative glycemic level postpercutaneous
coronary intervention (PCI) and adverse prognosis in non-ST-segment elevation acute
coronary syndrome (NSTE-ACS) patients is relatively inadequate.
Objective: The study aimed to identify whether the glycemic level post-PCI predicts adverse prognosis
in NSTE-ACS patients.
Methods: Patients (n=2465) admitted with NSTE-ACS who underwent PCI were enrolled. The relative
glycemic level post-procedure was calculated as blood glucose level post-PCI divided by HbA1c level,
which was named post-procedural glycemic index (PGI). The primary observational outcome of this
study was major adverse cardiovascular events (MACE) [defined as a composite of all-cause death,
non-fatal myocardial infarction (MI) and any revascularization].
Results: The association between PGI and MACE rate is presented as a U-shape curve. Higher PGIs
[hazard ratio (HR): 1.669 (95% confidence interval (CI): 1.244-2.238) for the third quartile (Q3) and
2.076 (1.566-2.753) for the fourth quartile (Q4), p<0.001], adjusted for confounding factors, were considered
to be one of the independent predictors of MACE. The association between the PGI and the risk
of MACE was more prominent in the non-diabetic population [HR (95%CI) of 2.356 (1.456-3.812) for
Q3 and 3.628 (2.265-5.812) for Q4, p<0.001]. There were no significant differences in MACE risk between
PGI groups in the diabetic population.
Conclusion: Higher PGI was a significant and independent predictor of MACE in NSTE-ACS patients
treated with PCI. The prognostic effect of the PGI is more remarkable in subsets without pre-existing
diabetes than in the overall population. The predictive value of PGI was not identified in the subgroup
with diabetes.
