TCT-251 Abnormal glucose metabolism and adverse event rates 12 months after treatment with contemporary drug-eluting stents: Insights from the BIO-RESORT Silent Diabetes study

BACKGROUND: Patients with abnormal glucose metabolism, including patients with undetected and thus untreated diabetes, may have higher event risks after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES). We assessed the prevalence and clinical impact of abnormal glucose metabolism in allcomer patients without previously known diabetes undergoing PCI.

METHODS: The BIO-RESORT Silent Diabetes study, performed at Thoraxcentrum Twente, is a substudy of the randomized BIO-RESORT trial (NCT01674803). We performed an additional analysis identifying patients with an abnormal glucose metabolism by means of oral glucose tolerance testing (OGTT), and assessment of glycated hemoglobin A1c (HbA1c) with fasting plasma glucose (FPG) and clinical outcome at 12 months.

RESULTS: Assessment of glucose metabolism revealed that of the 988 participants a total 330 (33.4%) patients had an abnormal metabolism, while 658 (66.6%) patients had a normal metabolism. Patients with abnormal glucose metabolism showed higher rates of the primary endpoint Target Vessel Failure (6.4% vs. 2.7%; p0.01), a composite of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization. Multivariate analysis demonstrated that an abnormal glucose metabolism independently predicted adverse event risk (HR 2.2, 95%-CI:1.2-4.2).

CONCLUSION: Abnormal glucose metabolism was detected in one out of three PCI all-comer patients and independently associated with a more than 2-fold higher event risk. Future intervention studies should determine whether meaningful benefits may accrue from routine glycaemia testing in such patients.