| Effect of baseline glycemic level on long-term cardiovascular outcomes after coronary revascularization therapy in patients with type 2 diabetes mellitus treated with hypoglycemic agents. | |
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MedLine Citation:
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PMID: 20346313 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The present study evaluated the association between preoperative hemoglobin A1c (HbA1c) levels and cardiovascular outcomes in patients with type 2 diabetes mellitus (DM) treated with hypoglycemic agents and undergoing coronary revascularization. We conducted a multicenter registry of Japanese patients undergoing first elective coronary revascularization. The present study included 3,571 patients whose HbA1c value at the index hospitalization was available. Of the 3,571 patients, 2,067 did not have DM and 1,504 had type 2 DM. Of the patients with type 2 DM, 202 had a HbA1c level of <6% (very low HbA1c group [VLG]), 426 had a HbA1c level of > or =6% but <7% (low HbA1c group), 405 had a HbA1c level of '7% but <8% (intermediate HbA1c group), and 471 had a HbA1c level of > or =8% (high HbA1c group). The patients with type 2 DM treated with diet only were not included in the present study. The VLG had the lowest rate of freedom from major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke. On multivariate analyses, the low HbA1c group had the lowest hazard ratio for MACE relative to those without DM (hazard ratio 1.13, 95% confidence interval 0.80 to 1.55). The VLG, intermediate HbA1c group, and high HbA1c group were significantly associated with an increased risk of MACE. On multivariate analyses of patients with DM using the low HbA1c group as a reference, a high HbA1c group level was significantly associated with an increased risk of MACE. The VLG and intermediate HbA1c group tended to be associated with an increased risk of MACE (VLG, hazard ratio 1.54, 95% confidence interval 0.98 to 2.40; intermediate HbA1c group, hazard ratio 1.44, 95% confidence interval 0.98 to 2.13). In conclusion, patients with type 2 DM treated with hypoglycemic agents and undergoing first elective coronary revascularization had significantly worse cardiovascular outcomes than patients without DM, except for patients with DM and a HbA1c of 6% to 7%. In the patients with DM, those with a HbA1c of 6% to 7% tended to have the lowest risk of MACE. |
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Authors:
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Natsuhiko Ehara; Takeshi Morimoto; Yutaka Furukawa; Satoshi Shizuta; Ryoji Taniguchi; Yoshihisa Nakagawa; Kozo Hoshino; Naritatsu Saito; Takahiro Doi; Yoshisumi Haruna; Neiko Ozasa; Yukiko Imai; Satoshi Teramukai; Masanori Fukushima; Toru Kita; Takeshi Kimura |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-02-13 |
Journal Detail:
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Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-29 Completed Date: 2010-04-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 960-6 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiology, Kobe City Medical Center General Hospital, Kobe, Japan. natsu@kcgh.gr.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiovascular Diseases / blood* Diabetes Complications / blood* Diabetes Mellitus, Type 2 / complications*, drug therapy* Female Hemoglobin A, Glycosylated / analysis* Humans Hypoglycemic Agents / therapeutic use* Male Myocardial Revascularization* Risk Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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