1792-LB: Long-Term Impact of Glucose Status on Risk of Restenosis after Percutaneous Transluminal Coronary Angioplasty—A Six-Year Follow-up Study

Patients with diabetes (DM) are at high risk for restenosis after coronary stenting. Information relating the long-term outcome of percutaneous transluminal coronary angioplasty (PTCA) to prediabetes is, however, limited. We retrospectively analyzed data of 951 patients (mean age 59.5±4.2 yrs, 60.5% of men, mean history of coronary heart disease 9.1±1.1 yrs) who undertook PTCA at Emergency Department between Jan 2008 and Dec 2011. Baseline measures included blood pressure (BP), fasting plasma glucose, lipid profile, A1c, C-reactive protein (C-RP), and 2-hour capillary glucose. All patients had follow-up coronary CTA 6 year after PTCA. Restenosis was defined as ≧ 50% stenosis in stent or within 5 mm adjacent to stent. The rate of restenosis was compared among patients with normal glucose tolerance (NGT, n=407), impaired glucose regulation (IGR, n=263), and DM (n=281) according to their baseline glucose levels or prior history of DM. Patients with DM had highest levels of body mass index (BMI), BP, triglycerides (TG), and C-RP, followed by those with IGR and NGT (P<0.01).The number of lesion was 1.6, 1.8, and 2.6 in patients with NGT, IGR, and DM, respectively (p<0.05). At year 6, the rate of restenosis, evaluated by coronary CTA, were 4.8%, 6.5%, and 14.2% in patients with NGT, IGT, and DM, respectively (P<0.05). Among DM subgroup, compared with patients with A1c<8%, those with A1c>8% had increased rate of restenosis (15.8% vs. 12.4%, P<0.05). In the logistic regression model, the odd ratio (OR) of having restenosis was 1.52 (95%CI: 1.03-2.90) for DM and 1.11 (95% CI: 1.01-1.54) for IGR, after adjusting for age, history of CHD, BMI, BP, LDL-C, TG, A1c and C-RP. Restenosis is more frequent in patients with compared those without DM. Prediabetes is associated with increased risk of restenosis after PTCA during a long-term follow-up period. The data indicates that intervention of hyperglycemia should be addressed in CHD patients even in those with prediabetes.