Impact of prediabetes and diabetes on 3-year outcome of patients treated with new-generation drug-eluting stents in two large-scale randomized clinical trials

Autor: Marlies M. Kok, Tineke H. Pinxterhuis, Peter W. Danse, Eline H. Ploumen, Clemens von Birgelen, Paolo Zocca, Ariel Roguin, Rutger L. Anthonio, Adel Aminian, Carine J.M. Doggen, Edouard Benit, Carl E. Schotborgh
Přispěvatelé: Health Technology & Services Research, TechMed Centre
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Blood Glucose
Male
Time Factors
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Coronary artery disease
law.invention
Percutaneous coronary intervention
Diabetes mellitus
Randomized controlled trial
law
Risk Factors
Myocardial infarction
Prediabetes
Drug-eluting stents
Original Investigation
Randomized Controlled Trials as Topic
education.field_of_study
trial
Middle Aged
Treatment Outcome
Percutaneous
Female
Randomized clinical trial
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Population
Hemorrhage
Prosthesis Design
Risk Assessment
Prediabetic State
Internal medicine
medicine
Humans
Hypoglycemic Agents
Diseases of the circulatory (Cardiovascular) system
education
Glycemic
Aged
Glycated Hemoglobin
business.industry
Coronary Thrombosis
medicine.disease
coronary intervention
Randomized clinical
RC666-701
business
Zdroj: Cardiovascular Diabetology, Vol 20, Iss 1, Pp 1-11 (2021)
Cardiovascular Diabetology
Cardiovascular diabetology, 20(1):217. BioMed Central
ISSN: 1475-2840
0167-4803
Popis: Background Diabetes is associated with adverse outcomes after percutaneous coronary intervention with drug-eluting stents (DES), but for prediabetes this association has not been definitely established. Furthermore, in patients with prediabetes treated with contemporary stents, bleeding data are lacking. We assessed 3-year ischemic and bleeding outcomes following treatment with new-generation DES in patients with prediabetes and diabetes as compared to normoglycemia. Methods For this post-hoc analysis, we pooled patient-level data of the BIO-RESORT and BIONYX stent trials which both stratified for diabetes at randomization. Both trials were multicenter studies performed in tertiary cardiac centers. Study participants were patients of whom glycemic state was known based on hemoglobin A1c, fasting plasma glucose, or medically treated diabetes. Three-year follow-up was available in 4212/4330 (97.3 %) patients. The main endpoint was target vessel failure, a composite of cardiac death, target vessel myocardial infarction, or target vessel revascularization. Results Baseline cardiovascular risk profiles were progressively abnormal in patients with normoglycemia, prediabetes, and diabetes. The main endpoint occurred in 54/489 patients with prediabetes (11.2 %) and 197/1488 with diabetes (13.7 %), as compared to 142/2,353 with normoglycemia (6.1 %) (HR: 1.89, 95 %-CI 1.38–2.58, p Conclusions Not only patients with diabetes but also patients with prediabetes represent a high-risk population. After treatment with new-generation DES, both patient groups had higher risks of ischemic and bleeding events. Differences in major bleeding were mainly attributable to dissimilarities in baseline characteristics. Routine assessment of glycemic state may help to identify patients with prediabetes for intensified management of cardiovascular risk factors. Trial registration: BIO-RESORT ClinicalTrials.gov: NCT01674803, registered 29-08-2012; BIONYX ClinicalTrials.gov: NCT02508714, registered 27-7-2015.
Databáze: OpenAIRE
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