Glycosylated hemoglobin is a predictor of major adverse cardiac events after drug-eluting stent implantation in patients with diabetes mellitus.
OBJECTIVE
Diabetes mellitus is associated with the risk of restenosis and mortality after coronary stenting, but the relation between glycosylated hemoglobin (hemoglobin A1c) and prognosis has not yet been fully elucidated in patients with diabetes mellitus. The purpose of this study was to evaluate whether hemoglobin A1c is associated with a risk of major adverse cardiac events (MACE) after successful drug-eluting stent (DES) implantation in patients with diabetes mellitus.


METHODS
In a retrospective study with a prospective follow-up, 206 patients with diabetes mellitus undergoing successful DES implantation were enrolled in this study. Hemoglobin A1c levels were measured within 1 month before coronary stenting.


RESULTS
During a period of 4,811 person-months, we confirmed 40 cases of MACE. Higher hemoglobin A1c levels increased the incidence of MACE. Based on multivariate analysis, hemoglobin A1c was a significant predictor of MACE. The multiple-adjusted hazard ratio for a 1% increase in hemoglobin A1c levels was 1.40 (95% CI: 1.13-1.74, p = 0.002) for MACE after adjustment for age, gender, ejection fraction, chronic renal failure on hemodialysis, and statins.


CONCLUSIONS
Hemoglobin A1c is associated with an increased risk of MACE after successful DES implantation in patients with diabetes mellitus.
Ueda
Hiroyasu
H
Department of Cardiology, Sumitomo Hospital, Osaka, Japan.
Mitsusada
Nobuhiro
N
Harimoto
Kuniyasu
K
Miyawaki
Masami
M
Yasuga
Yuji
Y
Hiraoka
Hisatoyo
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000378:metabolism / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006333:Heart Failure / Q000378:metabolism / Q000401:mortality; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000378:metabolism / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
D006442:Glycated Hemoglobin