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Prognostic role of preprocedural glucose levels on short- and long-term outcome in patients undergoing percutaneous coronary revascularization.
Catheter Cardiovasc Interv. 2012 Sep 01; 80(3):377-84.CC

Abstract

OBJECTIVES

We investigated the prognostic role of preprocedural blood glucose levels (BGLs) on short- and long-term outcome in patients undergoing elective percutaneous coronary intervention (PCI).

BACKGROUND

Hyperglycemia and hypoglycemia, with or without pre-existing diabetes mellitus, are associated with adverse outcome in patients with coronary artery disease. Moreover, neointimal hyperplasia after coronary stent implantation is increased in presence of suboptimal glycemic control.

METHODS

Preprocedural BGLs were prospectively measured in 572 patients and predefined groups were considered: hypoglycemia ≤ 80 mg/dl; euglycemia 81-109 mg/dl; mild hyperglycemia 110-125 mg/dl; hyperglycemia ≥ 126 mg/dl. Primary end point was represented by the incidence of peri-procedural myocardial infarction (MI) and secondary end point was the occurrence of major adverse cardiac events (MACE) at follow-up.

RESULTS

Hypoglycemia was associated with an increased risk of peri-procedural MI (51% vs 30%, 29%, and 37% in euglycemia, mild hyperglycemia and hyperglycemia groups, respectively; P for trend 0.025). After a mean follow-up of 15 ± 8 months, the occurrence of MACE was 38% in the hypoglycemia group, 12% in the euglycemia group, 14% in the mild hyperglycemia and 22% in the hyperglycemia group (P < 0.001). The incidence of in-stent restenosis and target vessel revascularization was also higher in patients with abnormal pre-procedural BGLs (P for trend 0.007 and <0.001, respectively). Multivariate analysis confirmed hypoglycemia as a predictor of early and long-term unfavorable cardiac prognosis (OR = 2.53, 95% CI 1.09-5.81, P = 0.029 for peri-procedural MI; OR = 2.91, 95% CI 1.26-6.69, P = 0.012 for MACE occurrence).

CONCLUSIONS

We observed a significant association between preprocedural BGLs and adverse short-and long-term outcome in patients undergoing elective PCI. Thus, a careful glycemic monitoring should be recommended in all patients undergoing coronary stenting, irrespective of the diabetic status.

Authors+Show Affiliations

Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21681905

Citation

Nusca, Annunziata, et al. "Prognostic Role of Preprocedural Glucose Levels On Short- and Long-term Outcome in Patients Undergoing Percutaneous Coronary Revascularization." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 80, no. 3, 2012, pp. 377-84.
Nusca A, Patti G, Marino F, et al. Prognostic role of preprocedural glucose levels on short- and long-term outcome in patients undergoing percutaneous coronary revascularization. Catheter Cardiovasc Interv. 2012;80(3):377-84.
Nusca, A., Patti, G., Marino, F., Mangiacapra, F., D'Ambrosio, A., & Di Sciascio, G. (2012). Prognostic role of preprocedural glucose levels on short- and long-term outcome in patients undergoing percutaneous coronary revascularization. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 80(3), 377-84. https://doi.org/10.1002/ccd.23185
Nusca A, et al. Prognostic Role of Preprocedural Glucose Levels On Short- and Long-term Outcome in Patients Undergoing Percutaneous Coronary Revascularization. Catheter Cardiovasc Interv. 2012 Sep 1;80(3):377-84. PubMed PMID: 21681905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic role of preprocedural glucose levels on short- and long-term outcome in patients undergoing percutaneous coronary revascularization. AU - Nusca,Annunziata, AU - Patti,Giuseppe, AU - Marino,Francesco, AU - Mangiacapra,Fabio, AU - D'Ambrosio,Andrea, AU - Di Sciascio,Germano, Y1 - 2011/06/16/ PY - 2010/11/19/received PY - 2011/03/26/accepted PY - 2011/6/18/entrez PY - 2011/6/18/pubmed PY - 2013/1/31/medline SP - 377 EP - 84 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 80 IS - 3 N2 - OBJECTIVES: We investigated the prognostic role of preprocedural blood glucose levels (BGLs) on short- and long-term outcome in patients undergoing elective percutaneous coronary intervention (PCI). BACKGROUND: Hyperglycemia and hypoglycemia, with or without pre-existing diabetes mellitus, are associated with adverse outcome in patients with coronary artery disease. Moreover, neointimal hyperplasia after coronary stent implantation is increased in presence of suboptimal glycemic control. METHODS: Preprocedural BGLs were prospectively measured in 572 patients and predefined groups were considered: hypoglycemia ≤ 80 mg/dl; euglycemia 81-109 mg/dl; mild hyperglycemia 110-125 mg/dl; hyperglycemia ≥ 126 mg/dl. Primary end point was represented by the incidence of peri-procedural myocardial infarction (MI) and secondary end point was the occurrence of major adverse cardiac events (MACE) at follow-up. RESULTS: Hypoglycemia was associated with an increased risk of peri-procedural MI (51% vs 30%, 29%, and 37% in euglycemia, mild hyperglycemia and hyperglycemia groups, respectively; P for trend 0.025). After a mean follow-up of 15 ± 8 months, the occurrence of MACE was 38% in the hypoglycemia group, 12% in the euglycemia group, 14% in the mild hyperglycemia and 22% in the hyperglycemia group (P < 0.001). The incidence of in-stent restenosis and target vessel revascularization was also higher in patients with abnormal pre-procedural BGLs (P for trend 0.007 and <0.001, respectively). Multivariate analysis confirmed hypoglycemia as a predictor of early and long-term unfavorable cardiac prognosis (OR = 2.53, 95% CI 1.09-5.81, P = 0.029 for peri-procedural MI; OR = 2.91, 95% CI 1.26-6.69, P = 0.012 for MACE occurrence). CONCLUSIONS: We observed a significant association between preprocedural BGLs and adverse short-and long-term outcome in patients undergoing elective PCI. Thus, a careful glycemic monitoring should be recommended in all patients undergoing coronary stenting, irrespective of the diabetic status. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/21681905/Prognostic_role_of_preprocedural_glucose_levels_on_short__and_long_term_outcome_in_patients_undergoing_percutaneous_coronary_revascularization_ L2 - https://doi.org/10.1002/ccd.23185 DB - PRIME DP - Unbound Medicine ER -