title: Impact of post-challenge hyperglycemia on clinical outcomes in Japanese patients with stable angina undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  Post-challenge hyperglycemia (PH) is well-established as one of risk factors for coronary artery disease. However, it remains unclear whether PH affects clinical outcomes in patients with stable angina undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 828 patients with stable angina undergoing PCI were retrospectively analyzed. Of these, 452 patients with previously diagnosed diabetes mellitus (DM) or fasting plasma glucose (PG) ≥126 mg/dl and HbA1c ≥6.5% were defined as known DM. The remaining 376 patients were divided into the two groups according to 2-h PG: PH (2-h PG ≥140 mg/dl, n=236) and normal glucose tolerance (NGT, 2-h PG <140 mg/dl, n=140). We assessed the rate of major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, and clinically-driven revascularization.
  
  
  RESULTS
  During the median follow-up of 4.3 years, the MACE rate was significantly higher in the DM and PH groups than the NGT group (39.3% vs. 20.7%, P <0.001; 31.4% vs. 20.7%, P=0.044, respectively). Compared with the NGT group, the cumulative incidence of revascularization was significantly higher in the DM group (35.1% vs. 18.5%, P <0.001) and tended to be higher in the PH group (27.1% vs. 18.5%, P=0.067). In the multivariate analysis, known DM (Hazard ratio [HR]: 2.16, 95% confidence interval (CI): 1.49-3.27, P < 0.001), PH (HR: 1.62, 95% CI: 1.07-2.53, P = 0.023), LDL-C >100 mg/dl (HR: 1.62, 95% CI: 1.26 to 2.10, P < 0.001), and previous stroke (HR: 1.47, 95% CI: 1.03-2.04, P = 0.034) were predictors of MACE.
  
  
  CONCLUSIONS
  PH is associated with future cardiovascular events in patients with stable angina undergoing PCI.
authors: Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu 802-8555, Japan. kuramitsu@circulation.jp
authors: Shoichi
authors: S
authors: Kuramitsu
authors: Hiroyoshi
authors: H
authors: Yokoi
authors: Takenori
authors: T
authors: Domei
authors: Akihiro
authors: A
authors: Nomura
authors: Hirotoshi
authors: H
authors: Watanabe
authors: Kyohei
authors: K
authors: Yamaji
authors: Yoshimitsu
authors: Y
authors: Soga
authors: Takeshi
authors: T
authors: Arita
authors: Katsuhiro
authors: K
authors: Kondo
authors: Shinichi
authors: S
authors: Shirai
authors: Kenji
authors: K
authors: Ando
authors: Koyu
authors: K
authors: Sakai
authors: Masashi
authors: M
authors: Iwabuchi
authors: Hedeyuki
authors: H
authors: Nosaka
authors: Masakiyo
authors: M
authors: Nobuyoshi
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications*; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
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