%0 Journal Article
%T Glycosylated hemoglobin (HbA1c) levels and clinical outcomes in diabetic patients following coronary artery stenting
%A Seyed Kassaian
%A Hamidreza Goodarzynejad
%A Mohammad Boroumand
%A Mojtaba Salarifar
%A Farzad Masoudkabir
%A Mohammad Mohajeri-Tehrani
%A Hamidreza Pourhoseini
%A Saeed Sadeghian
%A Narges Ramezanpour
%A Mohammad Alidoosti
%A Elham Hakki
%A Soheil Saadat
%A Ebrahim Nematipour
%J Cardiovascular Diabetology
%D 2012
%I BioMed Central
%R 10.1186/1475-2840-11-82
%X We evaluated 2884 consecutive patients including 2181 non-diabetic patients and 703 diabetics who underwent coronary stenting. Diabetes mellitus was defined as the fasting blood sugar concentration ¡Ý 126£¿mg/dL, or the use of an oral hypoglycemic agent or insulin at the time of admission. Diabetic patients were categorized into two groups based on their mean HbA1c levels for three measurements (at 0, 1, and 6£¿months following procedure): 291 (41.4%) diabetics with good glycaemic control (HbA1c£¿¡Ü£¿7%) and 412 (58.6%) diabetics with poor glycaemic control (HbA1c£¿>£¿7%).The adjusted risk of MACE in diabetic patients with poor glycaemic control (HbA1c£¿>£¿7%) was 2.1 times of the risk in non-diabetics (adjusted HR£¿=£¿2.1, 95% CI: 1.10 to 3.95, p£¿=£¿0.02). However, the risk of MACE in diabetics with good glycaemic control (HbA1c£¿¡Ü£¿7%) was not significantly different from that of non-diabetics (adjusted HR£¿=£¿1.33, 95% CI: 0.38 to 4.68, p£¿=£¿0.66).Our data suggest that there is an association between good glycaemic control to obtain HbA1c levels ¡Ü7% (both pre-procedural glycaemic control and post-procedural) with a better clinical outcome after PCI.Despite recent advances in medical management and coronary revascularization, cardiovascular disease accounts for about 75% of all hospital admissions and 80% of deaths in diabetic patients [1]. Although the introduction of drug-eluting stents has reduced the rates of restenosis and clinical events after percutaneous coronary intervention (PCI), since the diabetes mellitus has been proved to be a strong risk factor for in-stent restenosis [2-4], restenosis after stent implantation remains the ¡°Achilles¡¯ heel¡± of PCI [5], and patients with diabetes still have poorer clinical outcomes compared with non-diabetics [6-10].The higher rates of restenosis in diabetic patients might be partly explained by exaggerated neointimal proliferation after stent implantation due to hyperinsulinemic state of diabetes [11]. Glycosylated hemoglobin (HbA1c)
%K Diabetes mellitus
%K Percutaneous coronary intervention
%K Glycaemic control
%K Major adverse cardiovascular events
%U http://www.cardiab.com/content/11/1/82