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Impact of HbA1c on Mid-term Angiographic and Clinical Outcomes in Drug-eluting Stent Era
고려대학교 구로병원 순환기내과
Kang-yin Chen, 나승운, Zhe Jin, Yoshiyasu Minami,김지훈, 나진오,서순용, 최철웅,김진원,김응주,박창규,서홍석,오동주
Background:Previous studies suggested that DM pts with optimal blood sugar control after PCI have similar rates of repeat PCI to those of without diabetes.Although HbA1c was considered as a good predictor of PCI outcomes in diabetic pts,it is unclear whether HbA1c still has a good predictive value in DES era.Method:231 DM pts who underwent PCI with DES (Cypher,Taxus orEndeavor) were enrolled.According to HbA1c level,pts were divided into optimal group(n=68 pts,104 lesions) and suboptimal group(n=163 pts,272 lesions).Optimal glycemic control was defined as HbA1c < 7%, and suboptimal control HbA1c≥7%.Angiographic and clinical outcomes up to 6 months were evaluated.Result:Optimal group and suboptimal group showed similar baseline characteristics except optimal group had lower levels of fast blood sugar than that of suboptimal group(150.19±60.4vs195.88±81.4,p=0.001).At 6 months, optimal group and suboptimal group showed similar angiographic outcomes including restenosis percent,late loss and incidence of binary restenosis. Clinical outcomes were similar between two groups (Table).Conclusion:Optimal glycemic control expressed by HbA1c level did not exert a negative impact on mid-term angiographic and clinical outcomes of DM pts who underwent PCI with DES.Long-term follow up with larger study population would be needed for the definite conclusion.

Table: Angiographic and Clinical Outcomes of optimal and suboptimal groups at 6 months

Variable, n (%)

Optimal group

(n=68 pts, 104 lesions)

Suboptimal group

(n=163 pts, 272 lesions)

P value

Restenosis percent, %

29.06±21.85

26.10±22.06

0.389

Binary restenosis

5 (4.8)

15 (5.5)

0.785

Late lose, mm

0.64±0.64

0.72±0.70

0.437

Cardiac death

1 (1.5)

6 (3.7)

0.677

Total death

3 (4.4)

11 (6.7)

0.763

Q-wave MI

0 (0)

0 (0)

--

TLR

1 (1.5)

1 (0.6)

0.503

TVR

1 (1.5)

1 (0.6)

0.503

TVR-MACE

4 (5.9)

12 (7.4)

0.784

Stent thrombosis

0 (0)

0 (0)

--



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