Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization

Objective our purpose was to examine whether the outcome of diabetic patients after successful percutaneous core nary revascularization (PCR) is influenced by the degree of control of hyperglycemia at the time of revascularization. Background Diabetic patients have a worse outcome after PCR. Methods we examined whether the degree of glycemic control (HbA(1c) levels) effected the occurrence of all-cause death and death/myocardial infarction among diabetic patients after successful PCR from October 1979 through December 1998. HbA(1c) was analyzed both as a continuous and a categorical variable (good [HbA(1c) <8.0%, n = 700], moderate [8.0% <less than or equal to> HbA(1c) less than or equal to 10%, n = 442], or poor [HbA(1c) > 10%, n = 231] control). Results Hba(1c) levels were determined of a median (25th, 75th interquartiles) of 3 (1, 10) days after the index procedure for patients with good control, 2 (1, 7) days for moderate control, and 2 (1, 6) days for poor control. Median Follow-up after successful PCR was 3.2 (1.2, 6.1) years, 3.9 (1.7, 6.3) years, and 4.7 (2.1, 7.1) years, respectively. HbA(1c) as a continuous variable did not have an impact on either death (hazard ratio [95% confidence interval] 1.04 [0.98-1.10]) or death/myocardial infarction (1.02 [0.98-1.07]). As a categorical variable, patients with moderate and poor control had a similar hazard of death (0.99 [0.78-1.26] and 1.14 [0.86-1.52], respectively) and death/myocardial infarction (1.01 [0.82-1.24] and 1.12 [0.87-1.45], respectively) relative to those with good control. Conclusions The degree of glycemic control among diabetic patients at the time of their index intervention did not have on impact on long-term outcomes after successful PCR.