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Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study

BACKGROUND: Patients with coronary disease may have unknown diabetes or prediabetes. We evaluated 3‐year outcomes after percutaneous coronary intervention (PCI) with contemporary drug‐eluting stents (DES) in patients with silent diabetes, prediabetes, and normoglycemia. METHODS: All BIO‐RESORT trial...

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Autores principales: Ploumen, Eline H., Buiten, Rosaly A., Kok, Marlies M., Doggen, Carine J.M., van Houwelingen, K. Gert, Stoel, Martin G., de Man, Frits H.A.F., Hartmann, Marc, Zocca, Paolo, Linssen, Gerard C.M., Doelman, Cees, Kant, Gert D., von Birgelen, Clemens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496069/
https://www.ncbi.nlm.nih.gov/pubmed/31625262
http://dx.doi.org/10.1002/ccd.28536
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author Ploumen, Eline H.
Buiten, Rosaly A.
Kok, Marlies M.
Doggen, Carine J.M.
van Houwelingen, K. Gert
Stoel, Martin G.
de Man, Frits H.A.F.
Hartmann, Marc
Zocca, Paolo
Linssen, Gerard C.M.
Doelman, Cees
Kant, Gert D.
von Birgelen, Clemens
author_facet Ploumen, Eline H.
Buiten, Rosaly A.
Kok, Marlies M.
Doggen, Carine J.M.
van Houwelingen, K. Gert
Stoel, Martin G.
de Man, Frits H.A.F.
Hartmann, Marc
Zocca, Paolo
Linssen, Gerard C.M.
Doelman, Cees
Kant, Gert D.
von Birgelen, Clemens
author_sort Ploumen, Eline H.
collection PubMed
description BACKGROUND: Patients with coronary disease may have unknown diabetes or prediabetes. We evaluated 3‐year outcomes after percutaneous coronary intervention (PCI) with contemporary drug‐eluting stents (DES) in patients with silent diabetes, prediabetes, and normoglycemia. METHODS: All BIO‐RESORT trial (NCT01674803) participants without known diabetes, enrolled at our center, were invited for oral glucose tolerance testing (OGTT) and measurements of fasting plasma glucose and glycated hemoglobin (HbA1c). RESULTS: OGTT detected silent diabetes in 68 (6.9%), prediabetes in 132 (13.4%), and normoglycemia in 788 (79.8%) of all 988 study participants. Follow‐up was available in 986 (99.8%) patients. The main endpoint target vessel failure (TVF: cardiac death, target vessel‐related myocardial infarction [MI], or target vessel revascularization) differed between groups (14.8, 9.9, and 5.6%; p = .002), driven by MI during the first 48 hr and by cardiac death (p < .001; p = .026). Between 48 hr and 3‐years, there was no significant between‐group difference in TVF, target vessel MI, and target vessel revascularization. Multivariable analysis demonstrated that silent diabetes was independently associated with TVF (adjusted HR: 2.52, 95%‐CI: 1.26–5.03). An alternative diagnostic approach—HbA1c and fasting plasma glucose—detected silent diabetes and prediabetes in 33 (3.3%) and 217 (22.0%) patients, and normoglycemia in 738 (74.7%); TVF rates were 12.1, 7.9, and 6.0% (p = .23). CONCLUSION: In patients without known diabetes, abnormal glucose metabolism by OGTT was independently associated with higher 3‐year TVF rates after PCI with contemporary DES. This difference was driven by periprocedural MI and cardiac death. After the first 48 hr, the rates of TVF, target vessel MI, and target vessel revascularization were low and did not differ significantly between metabolic groups.
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spelling pubmed-74960692020-09-25 Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study Ploumen, Eline H. Buiten, Rosaly A. Kok, Marlies M. Doggen, Carine J.M. van Houwelingen, K. Gert Stoel, Martin G. de Man, Frits H.A.F. Hartmann, Marc Zocca, Paolo Linssen, Gerard C.M. Doelman, Cees Kant, Gert D. von Birgelen, Clemens Catheter Cardiovasc Interv Coronary Artery Disease BACKGROUND: Patients with coronary disease may have unknown diabetes or prediabetes. We evaluated 3‐year outcomes after percutaneous coronary intervention (PCI) with contemporary drug‐eluting stents (DES) in patients with silent diabetes, prediabetes, and normoglycemia. METHODS: All BIO‐RESORT trial (NCT01674803) participants without known diabetes, enrolled at our center, were invited for oral glucose tolerance testing (OGTT) and measurements of fasting plasma glucose and glycated hemoglobin (HbA1c). RESULTS: OGTT detected silent diabetes in 68 (6.9%), prediabetes in 132 (13.4%), and normoglycemia in 788 (79.8%) of all 988 study participants. Follow‐up was available in 986 (99.8%) patients. The main endpoint target vessel failure (TVF: cardiac death, target vessel‐related myocardial infarction [MI], or target vessel revascularization) differed between groups (14.8, 9.9, and 5.6%; p = .002), driven by MI during the first 48 hr and by cardiac death (p < .001; p = .026). Between 48 hr and 3‐years, there was no significant between‐group difference in TVF, target vessel MI, and target vessel revascularization. Multivariable analysis demonstrated that silent diabetes was independently associated with TVF (adjusted HR: 2.52, 95%‐CI: 1.26–5.03). An alternative diagnostic approach—HbA1c and fasting plasma glucose—detected silent diabetes and prediabetes in 33 (3.3%) and 217 (22.0%) patients, and normoglycemia in 738 (74.7%); TVF rates were 12.1, 7.9, and 6.0% (p = .23). CONCLUSION: In patients without known diabetes, abnormal glucose metabolism by OGTT was independently associated with higher 3‐year TVF rates after PCI with contemporary DES. This difference was driven by periprocedural MI and cardiac death. After the first 48 hr, the rates of TVF, target vessel MI, and target vessel revascularization were low and did not differ significantly between metabolic groups. John Wiley & Sons, Inc. 2019-10-17 2020-08 /pmc/articles/PMC7496069/ /pubmed/31625262 http://dx.doi.org/10.1002/ccd.28536 Text en © 2019 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Coronary Artery Disease
Ploumen, Eline H.
Buiten, Rosaly A.
Kok, Marlies M.
Doggen, Carine J.M.
van Houwelingen, K. Gert
Stoel, Martin G.
de Man, Frits H.A.F.
Hartmann, Marc
Zocca, Paolo
Linssen, Gerard C.M.
Doelman, Cees
Kant, Gert D.
von Birgelen, Clemens
Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title_full Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title_fullStr Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title_full_unstemmed Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title_short Three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: From the BIO‐RESORT Silent Diabetes study
title_sort three‐year clinical outcome in all‐comers with “silent” diabetes, prediabetes, or normoglycemia, treated with contemporary coronary drug‐eluting stents: from the bio‐resort silent diabetes study
topic Coronary Artery Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496069/
https://www.ncbi.nlm.nih.gov/pubmed/31625262
http://dx.doi.org/10.1002/ccd.28536
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