The risk is dose-dependent, warned investigators reporting new evidence of stent failure in patients with diabetes losing glycemic control.
PARIS — For the first time, there is compelling evidence that the degree of poor glycemic control in patients with type 2 diabetes is a relative risk factor for stent failure after a percutaneous coronary intervention .
More significantly, they also found that each incremental increase in A1c carried a greater risk for stent failure. It was 25% higher among those with an A1c of 7.1%-8.0%, 30% among those ranging from 8.1% to 9.0%, and 46% among those ranging from 9.1% to 10.0%. These results remained remarkably consistent across analyses. There was no change in the relative risks when those treated with insulin were compared with those who were not. While the impact of poor glycemic control on the risk for stent failure was greater in patients younger than 65 years than in those who were older, the incremental relationship between degree of hyperglycemia and risk was the same.The study identified several specific risks associated with higher A1c.
There was a sign that low A1c may also increase the risk for stent failure. Those with an A1c below 5.5% had a 10% increase in risk, although it was not statistically significant.There are many mechanisms by which diabetes might increase the risk for adverse outcomes independent of elevated blood sugar.
Diabetes Mellitus Type Ii Type 2 Diabetes Type 2 DM T2DM T2D Stent Diabetes Thromboembolism Myocardial Infarction Hypertension Patient Safety Thrombosis Percutaneous Coronary Intervention PCI Coronary Angioplasty Angioplasty Percutaneous Transluminal Coronary Angioplasty Hyperglycemia Adverse Effects Side Effects Blood Body Mass Index BMI Hemoglobin A1c
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