Background: The effect of glycemic control on major cardiovascular (CV) and cerebrovascular events (MACCE) after percutaneous coronary intervention in patients with Type 2 diabetes (DM) remains controversial. Methods: We report an international, observational study on DM patients with coronary artery disease eligible for percutaneous coronary intervention. Patients with Type 1 diabetes and ST elevation myocardial infarction (MI) were not included. Clinical follow up and glycemic control as assessed by glycosylated hemoglobin (HbA1c) were obtained at 1 year. Results: A total of 1,036 patients aged 61.9 (+/-0.3) years were included. CV risk factors included smoking, hypercholesterolemia, hypertension and overweight in 49.7%, 78.2%, 76.6% and 47.6%, respectively. Clinical presentation included acute coronary syndrome, silent ischemia and stable angina in 22%, 15.6% and 30.8%, respectively. 1,687 coronary stenosis were treated with at least one Xience everolimus eluting stent (EES) in the the left main (n=52), the left anterior descending artery (n=744), the left circumflex artery (n=506) or the right coronary artery (n=538). The mean length and diameter of the implanted EES were 19.0+/-0.2mm and 2.88+/- 0.01mm, respectively. MACCE was observed in 95 (9.2%) patients: CV death (n=16 (1.5%)), myocardial infarction (n=8 (0.8%)), ischemia driven revascularization (66 (6.4%)) and ischemic stroke (n=5 (0.5%)). The MACCE rate was not significantly different among the low, intermediate and high tertile groups of HBA1c. Conclusions: The use of EES in a large population of DM2 patients is associated with a low MACCE rate at 1 year. No beneficial effect of good glycemic control as assessed by HBA1c on MACCE was observed in this “all-comer” diabetic population at 1 year.
Varenne, O., Majwal, T., Commeau, P., Al-Nooryani, A. A., Henry, P., Sinnaeve, P., & Ahmed, W. (2013). TCT-317 Impact of Glycemic Control on Cardiovascular Outcomes in Secondary Prevention of Diabetic Patients after a First Coronary Event. Insights from an international registry including 1,036 patients. Journal of the American College of Cardiology, 62(18), B101. https://doi.org/10.1016/j.jacc.2013.08.1054