1. Newly impaired glucose metabolism and prognosis after percutaneous revascularization
- Author
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Juan H. Alonso-Briales, Manuel F. Jiménez-Navarro, Francisco J. Tinahones, José M. Hernández-García, Eduardo de Teresa-Galván, Julia Fernández-Pastor, Alejandro Pérez-Cabeza, Carmen Ortiz-García, María J. Molina-Mora, and Lourdes Garrido-Sanchez
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Percutaneous ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Myocardial Ischemia ,Revascularization ,Patient Readmission ,Prediabetic State ,Percutaneous Coronary Intervention ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Odds Ratio ,Humans ,Myocardial infarction ,Longitudinal Studies ,Prospective Studies ,Macrovascular disease ,Aged ,Heart Failure ,Chi-Square Distribution ,business.industry ,Percutaneous coronary intervention ,General Medicine ,Fasting ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Logistic Models ,Treatment Outcome ,Heart failure ,Conventional PCI ,Multivariate Analysis ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Background: Clinical practice guidelines recommend ad hoc screening of diabetes in patients admitted for macrovascular disease; however, these recommendations are rarely followed in real practice. This study was undertaken to assess whether impaired glucose metabolism, newly diagnosed after percutaneous coronary intervention (PCI) or known diabetes, provides prognostic information. Methods : We studied 374 patients who underwent PCI. An oral glucose tolerance test was carried out in the known non-diabetic patients with fasting glucose < 7 mmol/L. Results : Eighty-one percent of the patients presented impaired glucose metabolism, from which 35.3% were previously diagnosed with diabetics, 21.4% were newly detected diabetics, and 24.3% were pre-diabetics. After a mean follow-up of 35.8 ± 13.4 months, only a known history of diabetes was an independent predictor of revascularization (OR = 2.03, p = 0.025), non-fatal acute myocardial infarction (OR = 2.70, p = 0.029) and readmission due to heart failure during the follow-up (OR = 3.82, p = 0.022). Conclusions: Screening for impaired glucose metabolism after PCI permits the detection of a high proportion of patients with abnormal glucose regulations. However, previously known diabetes remains the only independent predictor of cardiovascular events in the follow-up.
- Published
- 2013