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Impact of Intensive Glucose Control in Patients with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention: 3-Year Clinical Outcomes

Cardiovascular Center, Seoul National University Hospital, Seoul 03080, Korea
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The first two authors equally contributed to this work.
J. Clin. Med. 2020, 9(8), 2464; https://doi.org/10.3390/jcm9082464
Received: 6 July 2020 / Revised: 17 July 2020 / Accepted: 26 July 2020 / Published: 1 August 2020
We investigated whether intensive glucose control after percutaneous coronary intervention (PCI) improves clinical outcomes in diabetic patients. From the Grand-DES registry, we analyzed 2576 diabetic patients (median age 66 years, male 65.6%) who underwent PCI and had at least 2 records of HbA1c during the follow-up. Patients were categorized according to the mean HbA1c (≥7% or <7%). Primary outcome was major adverse cardiovascular event (MACE), a composite of cardiac death, non-fatal myocardial infarction, and any revascularization. During a median follow-up of 33.6 months, MACE occurred in 335 (13.0%) patients. Intensive glucose control with follow-up mean HbA1c < 7.0% (42.2%; n = 1087) was not associated with lower risk of MACE, compared to control with mean HbA1c ≥ 7.0% (adjusted hazard ratio [aHR] [95% confidence interval] 1.06 [0.82–1.37], p = 0.672). In subgroup analysis, patients with sustained HbA1c of <7.0% throughout the follow-up were not associated with a lower risk of MACE compared to those with sustained HbA1c of ≥7.0% (aHR 1.15 [0.71–1.89], p = 0.566). More intensive glucose control with mean HbA1c ≤ 6.5% was not associated with lower risk of MACE, compared to loose control with a mean HbA1c ≥ 8.0% (aHR 1.15 [0.71–1.86], p = 0.583). Intensive glucose control after PCI was not associated with better clinical outcomes in diabetic patients undergoing PCI than lenient control. View Full-Text
Keywords: diabetes mellitus; percutaneous coronary intervention; HbA1c; hyperglycemia diabetes mellitus; percutaneous coronary intervention; HbA1c; hyperglycemia
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MDPI and ACS Style

Park, J.; Han, J.-K.; Chang, M.; Ki, Y.-J.; Kang, J.; Yang, H.-M.; Cho, H.-J.; Park, K.W.; Kang, H.-J.; Koo, B.-K.; Kim, H.-S. Impact of Intensive Glucose Control in Patients with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention: 3-Year Clinical Outcomes. J. Clin. Med. 2020, 9, 2464.

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