TY - JOUR
T1 - Three-year clinical outcome in all-comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug-eluting stents
T2 - From the BIO-RESORT Silent Diabetes study
AU - Ploumen, Eline H.
AU - Buiten, Rosaly A.
AU - Kok, Marlies M.
AU - Doggen, Carine J.M.
AU - van Houwelingen, K. Gert
AU - Stoel, Martin G.
AU - de Man, Frits H.A.F.
AU - Hartmann, Marc
AU - Zocca, Paolo
AU - Linssen, Gerard C.M.
AU - Doelman, Cees J.A.
AU - Kant, Gert D.
AU - von Birgelen, Clemens
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background: Patients with coronary disease may have unknown diabetes or prediabetes. We evaluated 3-year outcomes after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) in patients with silent diabetes, prediabetes, and normoglycemia.Methods: All BIO-RESORT trial (NCT01674803) participants without known diabetes, enrolled at our center, were invited for oral glucose tolerance testing (OGTT) and measurements of fasting plasma glucose and glycated hemoglobin (HbA1c).Results: OGTT detected silent diabetes in 68 (6.9%), prediabetes in 132 (13.4%), and normoglycemia in 788 (79.8%) of all 988 study participants. Follow-up was available in 986 (99.8%) patients. The main endpoint target vessel failure (TVF: cardiac death, target vessel-related myocardial infarction [MI], or target vessel revascularization) differed between groups (14.8, 9.9, and 5.6%; p =.002), driven by MI during the first 48 hr and by cardiac death (p <.001; p =.026). Between 48 hr and 3-years, there was no significant between-group difference in TVF, target vessel MI, and target vessel revascularization. Multivariable analysis demonstrated that silent diabetes was independently associated with TVF (adjusted HR: 2.52, 95%-CI: 1.26–5.03). An alternative diagnostic approach—HbA1c and fasting plasma glucose—detected silent diabetes and prediabetes in 33 (3.3%) and 217 (22.0%) patients, and normoglycemia in 738 (74.7%); TVF rates were 12.1, 7.9, and 6.0% (p =.23).Conclusion: In patients without known diabetes, abnormal glucose metabolism by OGTT was independently associated with higher 3-year TVF rates after PCI with contemporary DES. This difference was driven by periprocedural MI and cardiac death. After the first 48 hr, the rates of TVF, target vessel MI, and target vessel revascularization were low and did not differ significantly between metabolic groups.
AB - Background: Patients with coronary disease may have unknown diabetes or prediabetes. We evaluated 3-year outcomes after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) in patients with silent diabetes, prediabetes, and normoglycemia.Methods: All BIO-RESORT trial (NCT01674803) participants without known diabetes, enrolled at our center, were invited for oral glucose tolerance testing (OGTT) and measurements of fasting plasma glucose and glycated hemoglobin (HbA1c).Results: OGTT detected silent diabetes in 68 (6.9%), prediabetes in 132 (13.4%), and normoglycemia in 788 (79.8%) of all 988 study participants. Follow-up was available in 986 (99.8%) patients. The main endpoint target vessel failure (TVF: cardiac death, target vessel-related myocardial infarction [MI], or target vessel revascularization) differed between groups (14.8, 9.9, and 5.6%; p =.002), driven by MI during the first 48 hr and by cardiac death (p <.001; p =.026). Between 48 hr and 3-years, there was no significant between-group difference in TVF, target vessel MI, and target vessel revascularization. Multivariable analysis demonstrated that silent diabetes was independently associated with TVF (adjusted HR: 2.52, 95%-CI: 1.26–5.03). An alternative diagnostic approach—HbA1c and fasting plasma glucose—detected silent diabetes and prediabetes in 33 (3.3%) and 217 (22.0%) patients, and normoglycemia in 738 (74.7%); TVF rates were 12.1, 7.9, and 6.0% (p =.23).Conclusion: In patients without known diabetes, abnormal glucose metabolism by OGTT was independently associated with higher 3-year TVF rates after PCI with contemporary DES. This difference was driven by periprocedural MI and cardiac death. After the first 48 hr, the rates of TVF, target vessel MI, and target vessel revascularization were low and did not differ significantly between metabolic groups.
KW - Diabetes mellitus
KW - Glycated hemoglobin
KW - Oral glucose tolerance testing
KW - Percutaneous Coronary Intervention (PCI)
KW - Prediabetes
KW - Second-generation drug-eluting stents
KW - UT-Hybrid-D
UR - http://www.scopus.com/inward/record.url?scp=85074402153&partnerID=8YFLogxK
U2 - 10.1002/ccd.28536
DO - 10.1002/ccd.28536
M3 - Article
C2 - 31625262
AN - SCOPUS:85074402153
SN - 1522-1946
VL - 96
SP - E110-E118
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 2
ER -
