• Jin Kyung Hwang, Seung Hwa Lee, Young Bin Song, Joonghyun Ahn, Keumhee Carriere, Mi Ja Jang, Taek Kyu Park, Seung-Hyuk Choi, Jeong Hoon Yang, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, and Joo-Yong Hahn.
• From the Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.K.H., Seung Hwa Lee, Y.B.S., M.J.J., T.K.P., S.-H.C., J.H.Y., J.-H.C., Sang Hoon Lee, H.-C.G., J.-Y.H.); Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea (J.A., K.C.); and Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Canada (K.C.).
• Circ Cardiovasc Interv. 2017 Apr 1; 10 (4).

BackgroundData on the association between glycemic control after percutaneous coronary intervention and clinical outcomes are limited and controversial in diabetic patients.Methods And ResultsWe studied 980 patients with type 2 diabetes mellitus undergoing percutaneous coronary intervention using drug-eluting stents. Based on 2-year glycosylated hemoglobin A (HbA1c) levels, we divided patients into 2 groups of HbA1c<7.0 (n=489) and HbA1c≥7.0 (n=491). Propensity score-matched analysis was performed in 322 pairs. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of cardiac death, myocardial infarction, repeat revascularization, or stroke. Median follow-up duration was 5.4 years. The 7-year incidence of MACCE was lower in the HbA1c<7.0 group than in the HbA1c≥7.0 group (26.9% versus 40.3%; adjusted hazard ratio, 0.75; 95% confidence interval, 0.57-0.98; P=0.03). After propensity score matching, the 7-year incidence of MACCE was still lower in the HbA1c<7.0 group than in the HbA1c≥7.0 group (27.5% versus 37.4%; hazard ratio, 0.71; 95% confidence interval, 0.52-0.97; P=0.03), mainly because of a reduction in repeat revascularization (19.9% versus 29.5%; hazard ratio, 0.66; 95% confidence interval, 0.47-0.93; P=0.02). In subgroup analyses, the benefit of glycemic control for MACCE was more prominent in patients with residual SYNTAX score (Synergy Between PCI With Taxus and Cardiac Surgery) >4 than in those with the residual SYNTAX score ≤4 (Pinteraction=0.004).ConclusionsHbA1c<7.0 measured 2 years after percutaneous coronary intervention was associated with a reduced rate of MACCE. Our data suggest that high HbA1c levels 2 years after percutaneous coronary intervention may identify a population at increased risk of adverse events, especially repeat revascularization.© 2017 American Heart Association, Inc.

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