J Korean Diabetes > Volume 11(4); 2010 > Article
The Journal of Korean Diabetes 2010;11(4):315-323.
DOI: https://doi.org/10.4093/kcd.2010.11.4.315   
제2형 당뇨병환자에서 관상동맥 성형술 시행 후 혈당 조절 정도에 따른 동맥경화증 진행의 예측
심우호, 이은해, 이영미, 김혜원, 김순애, 범선희, 김은숙, 조민호, 박종숙, 안철우, 차봉수, 김경래, 이현철
Glycemic Control during the Post-PTCA Period Impacts the Progression of Atherosclerosis as Determined through Follow-up Angiography of Patients with Type 2 Diabetes
Woo Ho Shim, Eun Hae Lee, Young Mi Lee, Hye Won Kim, Soon Ae Kim, Sun Hee Bum, Eun Sook Kim, Min Ho Cho, Jong Suk Park, Chul Woo Ahn, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee
Several studies have reported that HbA1c level is not a predictor of major adverse cardiovascular events (MACE). We investigated the effects of different degrees of glycemic control to address the need for additional percutaneous transluminal coronary angioplasty (PTCA) as determined by follow-up angiography. Methods: From a group of 887 diabetes patients who received a successful balloon angioplasty or drug eluting stent implantation, 232 patients who underwent a nine-month angiographic follow-up were enrolled in the study. Body mass index, blood pressure, ejection fraction, HbA1c, lipid profile, cystatin C level, medication list, and angiographic findings were serially reviewed from the initial intervention to the follow-up angiography. Results: Sixty-four patients received additional PTCA for a newly developed coronary lesion or restenosis of the previous intervention site, while there was no need for intervention in 168 patients. The only differences in anthropometric or biochemical parameters between the two groups were baseline HbA1c level (7.36% vs. 7.76%, P = 0.041), follow-up HbA1c (7.14% vs. 7.53%, P = 0.02) and mean HbA1c (7.25% vs. 7.64%, P = 0.012). Multiple linear regression identified poor glycemic control, represented by a higher mean HbA1c, to be an independent risk factor for predicting repeated PTCA (OR 1.606, 95% CI 1.07-2.42, P = 0.023). The measurement of HbA1c quartile showed that strict glycemic control (HbA1c 6.11 ± 0.29%) can reduce the risk of target lesion restenosis and the need for repeated PTCA. Conclusions: Glycemic control during the post-PTCA period is an independent risk factor for predicting the need for additional PTCA. (Korean Clinical Diabetes J 11:315-323, 2010)
Key Words: Diabetes mellitus, Coronary disease, Hemoglobin A1c
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