Abstract 13995: Glycosylated Hemoglobin is a Predictor of Adverse Cardiac Events After Coronary Stent Implantation Among Patients Without Diabetes Mellitus
The effect of glucose homeostasis and metabolic hormones on the outcome after percutaneous coronary interventions is controversial and has not been extensively investigated in non-diabetic patients.
We assessed the hypothesis that glucose metabolism and metabolic hormones such as leptin and adiponectin have a potential effect on the outcome after coronary stenting among patients without known diabetes mellitus.
In our prospective study, 300 patients underwent coronary angiography and stent implantation and during a 4-year follow-up the occurrence of adverse cardiovascular events (death, CVA, acute myocardial infarction, revascularization of target and non-target vessels) was investigated. Patients without known diabetes mellitus (n=250) and with adverse cardiovascular events (n=50) had significantly higher baseline levels of glycosylated hemoglobin (5.92±0.050 vs. 5.75±0.026, P<0.01) as compared to patients without adverse events (n=200). Fasting plasma glucose and plasma insulin levels and glucose levels during an oral glucose tolerance test were however not different. Leptin and adiponectin plasma concentrations and leptin/adiponectin ratio did not differ either between the two groups. By using a multivariate Cox regression analysis, after adjusting for body mass index, low density lipoprotein, glucose, insulin, leptin and adiponectin levels, glycosylated hemoglobin (HR = 2.104, 95% CI = 1.055-4.196, p<0.05) and age (HR = 1.032, 95% CI = 1.002-1.062, p<0.05) remained significant independent predictors of adverse cardiovascular events.
In conclusion, among patients without known diabetes mellitus even a subtle increase of glycosylated hemoglobin can predict adverse cardiovascular events after percutaneous coronary interventions.
- © 2011 by American Heart Association, Inc.