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Medicine (Baltimore). 2019 Aug;98(34):e16927. doi: 10.1097/MD.0000000000016927.

Influence of hypercholesterolemia and diabetes on long-term outcome in patients with stable coronary artery disease receiving percutaneous coronary intervention.

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Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung.
Department of Medicine, School of Medicine, Tzu Chi University, Hualien.
Laboratory of Epidemiology and Biostatistics, Changhua Christian Hospital, Changhua.
Department of Pediatric Emergency Medicine, China Medical University Children's Hospital.
Department of Medicine, College of Medicine, China Medical University.
Department of Public Health, Chung Shan Medical University.
Department of Pediatrics, Children's Hospital, China Medical University.
Department of Medical Research, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.


Coronary artery disease (CAD) is a life-threatening medical emergency which needs urgent medical attention. Percutaneous coronary intervention (PCI) is common and necessary for patients with CAD. The effect of hypercholesterolemia and diabetes on long-term outcomes in patients with stable CAD receiving PCI is unclear.In this study, patients with stable CAD who underwent PCI were prospectively divided into 4 groups according to the presence or absence of diabetes or hypercholesterolemia. Clinical characteristics, risk factors, medications, angiographic findings, and outcome predictors were analyzed and long-term outcomes compared between groups.Of the 1676 patients studied, those with hypercholesterolemia and diabetes had the highest all-cause mortality rate after PCI (P < .01); those with diabetes only had the highest cardiovascular (CV) mortality (P < .01). However, the 4 groups did not differ in rates of myocardial infarction (MI) or repeated PCI. In Kaplan-Meier survival analysis, patients with diabetes only had the highest rates of all-cause mortality and CV mortality (both P < .001). In the Cox proportional hazard model, patients with both hypercholesterolemia and diabetes had the highest risk of all-cause mortality (hazard ratio: 1.70), but groups did not differ in rates of MI, CV mortality, and repeated PCI.With or without hypercholesterolemia, diabetes adversely impacts long-term outcomes in patients receiving PCI. Diabetes mellitus seemed to be a more hazardous outcome predictor than hypercholesterolemia. Hypercholesterolemia and diabetes seemed to have an additive effect on all-cause mortality in patients after receiving PCI.

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