P2492The impact of diabetes mellitus newly diagnosed by glycated hemoglobin on outcomes in patients undergoing percutaneous coronary intervention - five years prospective follow up study

Abstract

Abstract Background Following percutaneous coronary interventions (PCI), both short and long terms ischemic outcomes are worse in patients with Diabetes Mellitus (DM) compared to those without DM. Methods We prospectively enrolled consecutive patients undergoing PCI. Glycated Hemoglobin (HbA1c) levels were assessed during the index hospitalization and newly diagnosed DM was defined as HbA1c≥6.5% in the absence of the previous diagnosis. The primary outcome was Major Adverse Cerebro and Cardiovascular Events (MACCE) defined as death, stroke, PCI or acute myocardial infarction at five years. Results Diabetes was previously diagnosed in 391 (34%) patients (DM group), 221 (19%) had newly diagnosed DM based on the HbA1c level and 539 (47%) did not have diabetes (Non-DM). In DM group HbA1c was 7.80±1.36% as compared with 7.62±1.30% in patients with newly diagnosed DM (p<0.001). These patients were younger (62.0±11.3 years) compared to DM (67.9±10.4 years) and non-DM (63.7±13.0) patients, p<0.001. five years MACCE rates were 37.8%, 65.5% and 42.5% in the non-DM, newly diagnosed DM and DM groups, respectively (p<0.001). Multivariate analysis showed that compared to non-DM, the adjusted two year hazard ratios for MACCE were 1.83 (p<0.001), 1.47 (p=0.01) and 0.52 (p=0.01) respectively in patients with known DM, newly diagnosed DM, and patients with newly diagnosis DM who had DM treatment started after PCI. Conclusion Newly diagnosed DM based on peri-procedural HbA1c is common and associated with increased short and long term risk for adverse outcomes. Our results show that the diagnosis and early treatment of diabetes in patients undergoing PCI should be included into the routine practice.