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

Objective our purpose was to examine whether the outcome of diabetic patien ts after successful percutaneous core nary revascularization (PCR) is influ enced by the degree of control of hyperglycemia at the time of revasculariz ation. 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 Dec ember 1998. HbA(1c) was analyzed both as a continuous and a categorical var iable (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 interquartil es) of 3 (1, 10) days after the index procedure for patients with good cont rol, 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 continuou s variable did not have an impact on either death (hazard ratio [95% confid ence 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], resp ectively) 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 t ime of their index intervention did not have on impact on long-term outcome s after successful PCR.