Prevalence of unrecognized diabetes, prediabetes and metabolic syndrome in patients undergoing elective percutaneous coronary intervention.
BACKGROUND
Diabetes mellitus (DM) and metabolic syndrome are important targets for secondary prevention in cardiovascular disease. However, the prevalence in patients undergoing elective percutaneous coronary intervention is not well defined. We aimed to analyse the prevalence and characteristics of patients undergoing percutaneous coronary intervention with previously unrecognized prediabetes, diabetes and metabolic syndrome.


METHODS
Data were collected from 740 patients undergoing elective percutaneous coronary intervention between November 2010 and March 2013 at a tertiary referral center. Prevalence of DM and prediabetes was evaluated using Haemoglobin A1c (A1c ≥ 6.5% for DM, A1c 5.7-6.4% for prediabetes). A modified definition was used for metabolic syndrome [three or more of the following criteria: body mass index ≥30 kg/m2; triglycerides ≥ 150 mg/dL; high density lipoprotein <40 mg/dL in men and <50 mg/dL in women; systolic blood pressure ≥ 130 mmHg and/or diastolic ≥ 85 mmHg; and A1c ≥ 5.7% or on therapy].


RESULTS
Mean age was 67 years, median body mass index was 28.2 kg/m(2) and 39% had known DM. Of those without known DM, 8.3% and 58.5% met A1c criteria for DM and for prediabetes at time of percutaneous coronary intervention. Overall, 54.9% met criteria for metabolic syndrome (69.2% of patients with DM and 45.8% of patients without DM).


CONCLUSIONS
Among patients undergoing elective percutaneous coronary intervention, a substantial number were identified with a new DM, prediabetes, and/or metabolic syndrome. Routine screening for an abnormal glucometabolic state at the time of revascularization may be useful for identifying patients who may benefit from additional targeting of modifiable risk factors.
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Revathi
R
Balakrishnan
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Jeffrey S
JS
Berger
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Lisa
L
Tully
New York University School of Medicine, New York, NY, USA.
Anish
A
Vani
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Binita
B
Shah
New York University School of Medicine, New York, NY, USA.
Joseph
J
Burdowski
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Edward
E
Fisher
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Arthur
A
Schwartzbard
Endocrinology, Veterans Administration New York Harbor Healthcare System, Brooklyn, NY, USA.
Steven
S
Sedlis
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Howard
H
Weintraub
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
James A
http://orcid.org/0000-0002-6615-8535
JA
Underberg
Cardiology, Veterans Administration New York Harbor Healthcare System, Brooklyn, NY, USA.
Ann
A
Danoff
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
James A
JA
Slater
Division of Cardiology, New York University Langone Medical Center, New York, NY, USA.
Eugenia
E
Gianos
D000368:Aged; D015331:Cohort Studies; D054059:Coronary Occlusion / Q000097:blood / Q000150:complications* / Q000601:surgery; D057210:Delayed Diagnosis; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000150:complications* / Q000601:surgery; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000150:complications* / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D011236:Prediabetic State / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D062606:Tertiary Care Centers
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
Haemoglobin A1c; cardiac catheterization; diabetes; glucose intolerance; metabolic syndrome; prediabetes