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Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry

BACKGROUND: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization. OBJECTIVES: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive int...

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Autores principales: Yamaji, Kyohei, Shiomi, Hiroki, Morimoto, Takeshi, Matsumura-Nakano, Yukiko, Ehara, Natsuhiko, Sakamoto, Hiroki, Takeji, Yasuaki, Yoshikawa, Yusuke, Yamamoto, Ko, Kato, Eri T., Imada, Kazuaki, Tada, Takeshi, Taniguchi, Ryoji, Nishikawa, Ryusuke, Tada, Tomohisa, Uegaito, Takashi, Ogawa, Tatsuya, Yamada, Miho, Takeda, Teruki, Eizawa, Hiroshi, Tamura, Nobushige, Tambara, Keiichi, Suwa, Satoru, Shirotani, Manabu, Tamura, Toshihiro, Inoko, Moriaki, Nishizawa, Junichiro, Natsuaki, Masahiro, Sakai, Hiroshi, Yamamoto, Takashi, Kanemitsu, Naoki, Ohno, Nobuhisa, Ishii, Katsuhisa, Marui, Akira, Tsuneyoshi, Hiroshi, Terai, Yasuhiko, Nakayama, Shogo, Yamazaki, Kazuhiro, Takahashi, Mamoru, Tamura, Takashi, Esaki, Jiro, Miki, Shinji, Onodera, Tomoya, Mabuchi, Hiroshi, Furukawa, Yutaka, Tanaka, Masaru, Komiya, Tatsuhiko, Soga, Yoshiharu, Hanyu, Michiya, Domei, Takenori, Ando, Kenji, Kadota, Kazushige, Minatoya, Kenji, Nakagawa, Yoshihisa, Kimura, Takeshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675601/
https://www.ncbi.nlm.nih.gov/pubmed/36411876
http://dx.doi.org/10.1016/j.jacasi.2021.12.012
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author Yamaji, Kyohei
Shiomi, Hiroki
Morimoto, Takeshi
Matsumura-Nakano, Yukiko
Ehara, Natsuhiko
Sakamoto, Hiroki
Takeji, Yasuaki
Yoshikawa, Yusuke
Yamamoto, Ko
Kato, Eri T.
Imada, Kazuaki
Tada, Takeshi
Taniguchi, Ryoji
Nishikawa, Ryusuke
Tada, Tomohisa
Uegaito, Takashi
Ogawa, Tatsuya
Yamada, Miho
Takeda, Teruki
Eizawa, Hiroshi
Tamura, Nobushige
Tambara, Keiichi
Suwa, Satoru
Shirotani, Manabu
Tamura, Toshihiro
Inoko, Moriaki
Nishizawa, Junichiro
Natsuaki, Masahiro
Sakai, Hiroshi
Yamamoto, Takashi
Kanemitsu, Naoki
Ohno, Nobuhisa
Ishii, Katsuhisa
Marui, Akira
Tsuneyoshi, Hiroshi
Terai, Yasuhiko
Nakayama, Shogo
Yamazaki, Kazuhiro
Takahashi, Mamoru
Tamura, Takashi
Esaki, Jiro
Miki, Shinji
Onodera, Tomoya
Mabuchi, Hiroshi
Furukawa, Yutaka
Tanaka, Masaru
Komiya, Tatsuhiko
Soga, Yoshiharu
Hanyu, Michiya
Domei, Takenori
Ando, Kenji
Kadota, Kazushige
Minatoya, Kenji
Nakagawa, Yoshihisa
Kimura, Takeshi
author_facet Yamaji, Kyohei
Shiomi, Hiroki
Morimoto, Takeshi
Matsumura-Nakano, Yukiko
Ehara, Natsuhiko
Sakamoto, Hiroki
Takeji, Yasuaki
Yoshikawa, Yusuke
Yamamoto, Ko
Kato, Eri T.
Imada, Kazuaki
Tada, Takeshi
Taniguchi, Ryoji
Nishikawa, Ryusuke
Tada, Tomohisa
Uegaito, Takashi
Ogawa, Tatsuya
Yamada, Miho
Takeda, Teruki
Eizawa, Hiroshi
Tamura, Nobushige
Tambara, Keiichi
Suwa, Satoru
Shirotani, Manabu
Tamura, Toshihiro
Inoko, Moriaki
Nishizawa, Junichiro
Natsuaki, Masahiro
Sakai, Hiroshi
Yamamoto, Takashi
Kanemitsu, Naoki
Ohno, Nobuhisa
Ishii, Katsuhisa
Marui, Akira
Tsuneyoshi, Hiroshi
Terai, Yasuhiko
Nakayama, Shogo
Yamazaki, Kazuhiro
Takahashi, Mamoru
Tamura, Takashi
Esaki, Jiro
Miki, Shinji
Onodera, Tomoya
Mabuchi, Hiroshi
Furukawa, Yutaka
Tanaka, Masaru
Komiya, Tatsuhiko
Soga, Yoshiharu
Hanyu, Michiya
Domei, Takenori
Ando, Kenji
Kadota, Kazushige
Minatoya, Kenji
Nakagawa, Yoshihisa
Kimura, Takeshi
author_sort Yamaji, Kyohei
collection PubMed
description BACKGROUND: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization. OBJECTIVES: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive interventions. METHODS: The study population consisted of 39,427 patients (diabetes: n = 15,561; nondiabetes: n = 23,866) who underwent first percutaneous coronary intervention (n = 33,144) or coronary artery bypass graft (n = 6,283) in the pooled CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Graft) registry. The primary outcome measure was major adverse cardiovascular and cerebral endpoints (MACCE), which was defined as a composite of all-cause death, myocardial infarction, and stroke. RESULTS: With median follow-up of 5.6 years, diabetes was associated with significantly higher adjusted risks for MACCE. The excess adjusted risks of diabetes relative to nondiabetes for MACCE increased with younger age (≤64 years: adjusted HR: 1.30; 95% CI: 1.19-1.41; P < 0.001; 64-73 years: adjusted HR: 1.24; 95% CI: 1.16-1.33; P < 0.001; >73 years: adjusted HR: 1.17; 95% CI: 1.10-1.23; P < 0.001; P(interaction) < 0.001), mainly driven by greater excess adjusted mortality risk of diabetes relative to nondiabetes in younger tertile. No significant interaction was observed between adjusted risk of diabetes relative to nondiabetes for MACCE and other subgroups such as sex, mode of revascularization, and clinical presentation of acute myocardial infarction. CONCLUSIONS: The excess risk of diabetes relative to nondiabetes for MACCE was profound in the younger population. This observation suggests more aggressive interventions for secondary prevention in patients with diabetes might be particularly relevant in younger patients.
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spelling pubmed-96756012022-11-20 Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry Yamaji, Kyohei Shiomi, Hiroki Morimoto, Takeshi Matsumura-Nakano, Yukiko Ehara, Natsuhiko Sakamoto, Hiroki Takeji, Yasuaki Yoshikawa, Yusuke Yamamoto, Ko Kato, Eri T. Imada, Kazuaki Tada, Takeshi Taniguchi, Ryoji Nishikawa, Ryusuke Tada, Tomohisa Uegaito, Takashi Ogawa, Tatsuya Yamada, Miho Takeda, Teruki Eizawa, Hiroshi Tamura, Nobushige Tambara, Keiichi Suwa, Satoru Shirotani, Manabu Tamura, Toshihiro Inoko, Moriaki Nishizawa, Junichiro Natsuaki, Masahiro Sakai, Hiroshi Yamamoto, Takashi Kanemitsu, Naoki Ohno, Nobuhisa Ishii, Katsuhisa Marui, Akira Tsuneyoshi, Hiroshi Terai, Yasuhiko Nakayama, Shogo Yamazaki, Kazuhiro Takahashi, Mamoru Tamura, Takashi Esaki, Jiro Miki, Shinji Onodera, Tomoya Mabuchi, Hiroshi Furukawa, Yutaka Tanaka, Masaru Komiya, Tatsuhiko Soga, Yoshiharu Hanyu, Michiya Domei, Takenori Ando, Kenji Kadota, Kazushige Minatoya, Kenji Nakagawa, Yoshihisa Kimura, Takeshi JACC Asia Original Research BACKGROUND: Diabetes is a well-known risk factor for adverse outcomes after coronary revascularization. OBJECTIVES: This study sought to determine high-risk subgroups in whom the excess risks of diabetes relative to nondiabetes are particularly prominent and thus may benefit from more aggressive interventions. METHODS: The study population consisted of 39,427 patients (diabetes: n = 15,561; nondiabetes: n = 23,866) who underwent first percutaneous coronary intervention (n = 33,144) or coronary artery bypass graft (n = 6,283) in the pooled CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Graft) registry. The primary outcome measure was major adverse cardiovascular and cerebral endpoints (MACCE), which was defined as a composite of all-cause death, myocardial infarction, and stroke. RESULTS: With median follow-up of 5.6 years, diabetes was associated with significantly higher adjusted risks for MACCE. The excess adjusted risks of diabetes relative to nondiabetes for MACCE increased with younger age (≤64 years: adjusted HR: 1.30; 95% CI: 1.19-1.41; P < 0.001; 64-73 years: adjusted HR: 1.24; 95% CI: 1.16-1.33; P < 0.001; >73 years: adjusted HR: 1.17; 95% CI: 1.10-1.23; P < 0.001; P(interaction) < 0.001), mainly driven by greater excess adjusted mortality risk of diabetes relative to nondiabetes in younger tertile. No significant interaction was observed between adjusted risk of diabetes relative to nondiabetes for MACCE and other subgroups such as sex, mode of revascularization, and clinical presentation of acute myocardial infarction. CONCLUSIONS: The excess risk of diabetes relative to nondiabetes for MACCE was profound in the younger population. This observation suggests more aggressive interventions for secondary prevention in patients with diabetes might be particularly relevant in younger patients. Elsevier 2022-04-12 /pmc/articles/PMC9675601/ /pubmed/36411876 http://dx.doi.org/10.1016/j.jacasi.2021.12.012 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Yamaji, Kyohei
Shiomi, Hiroki
Morimoto, Takeshi
Matsumura-Nakano, Yukiko
Ehara, Natsuhiko
Sakamoto, Hiroki
Takeji, Yasuaki
Yoshikawa, Yusuke
Yamamoto, Ko
Kato, Eri T.
Imada, Kazuaki
Tada, Takeshi
Taniguchi, Ryoji
Nishikawa, Ryusuke
Tada, Tomohisa
Uegaito, Takashi
Ogawa, Tatsuya
Yamada, Miho
Takeda, Teruki
Eizawa, Hiroshi
Tamura, Nobushige
Tambara, Keiichi
Suwa, Satoru
Shirotani, Manabu
Tamura, Toshihiro
Inoko, Moriaki
Nishizawa, Junichiro
Natsuaki, Masahiro
Sakai, Hiroshi
Yamamoto, Takashi
Kanemitsu, Naoki
Ohno, Nobuhisa
Ishii, Katsuhisa
Marui, Akira
Tsuneyoshi, Hiroshi
Terai, Yasuhiko
Nakayama, Shogo
Yamazaki, Kazuhiro
Takahashi, Mamoru
Tamura, Takashi
Esaki, Jiro
Miki, Shinji
Onodera, Tomoya
Mabuchi, Hiroshi
Furukawa, Yutaka
Tanaka, Masaru
Komiya, Tatsuhiko
Soga, Yoshiharu
Hanyu, Michiya
Domei, Takenori
Ando, Kenji
Kadota, Kazushige
Minatoya, Kenji
Nakagawa, Yoshihisa
Kimura, Takeshi
Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title_full Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title_fullStr Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title_full_unstemmed Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title_short Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization: CREDO-Kyoto PCI/CABG Registry
title_sort modifiers of the risk of diabetes for long-term outcomes after coronary revascularization: credo-kyoto pci/cabg registry
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675601/
https://www.ncbi.nlm.nih.gov/pubmed/36411876
http://dx.doi.org/10.1016/j.jacasi.2021.12.012
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