Abstract 1709: Undiagnosed Diabetic Patients Undergoing Elective Percutaneous Coronary Interventions Have a High Rate of Mortality
Background: The relationship between fasting plasma glucose levels and outcomes in patients undergoing non-emergent percutaneous coronary intervention (PCI) are not well defined.
Methods: Consecutive patients (n = 12,667) undergoing an elective PCI at our institution between June 1999 and December 2006 were followed through June 2007 for mortality. Using pre-procedure fasting plasma glucose levels, patients were categorized as having normal glucose (<100 mg/dL), impaired fasting glucose (100 to 125 mg/dL), undiagnosed diabetes mellitus (DM) (≥126 mg/dL and no known diagnosis of DM) and diagnosed DM (known diagnosis of DM). Mortality was assessed using the Social Security Death Index.
Results: The mean age of participants was 65.6 ± 12.1 years, 66% were male, 11% African American, and 17% Hispanic. Overall 24% of patients were categorized as having normal glucose level, 29% had impaired fasting glucose, 9% had undiagnosed diabetes mellitus and 39% had diagnosed DM. Over an average follow-up period of 3.4 years (maximum 8.0 years), 1,128 deaths occurred. Compared to patients with normal fasting plasma glucose, the crude mortality rate as well as the adjusted hazard ratio (95% confidence interval) of mortality were higher for patients with undiagnosed DM and diagnosed DM (Table⇓). In contrast, the mortality rate was similar for patients with normal and impaired fasting glucose.
Conclusion: In the population studied, almost 10% of patients undergoing elective PCI had undiagnosed diabetes mellitus. As these patients have an increased risk of mortality following PCI, the routine evaluation of fasting glucose in the work-up of PCI patients may be warranted.